Purpose

The purpose of this report is to outline the
procurement process for commissioning the Integrated Sexual Health
(ISH) services across Berkshire East (Bracknell Forest Council,
Royal Borough of Windsor and Maidenhead, and Slough Borough
Council), which will start from 1 July 2026, and seek approval for
the following:
To approve the procurement of an ISH service
under the new Contract Standing Orders (2024) and under the
Provider Selection Regime (2023) competitive process.
To approve the procurement for an initial term of
5 years (1 July 2026 – 30 June 2031) with two (2) 12-month
optional extensions.
To approve the delegation of authority to
Bracknell Forest to undertake the procurement on behalf of the
three (3) Berkshire East boroughs (Bracknell Forest, RBWM and
Slough)
To approve the delegation of authority to
Bracknell Forest Executive Director of Place to award the contract
to the successful bidder on behalf of the three (3) Berkshire East
boroughs (Bracknell Forest, RBWM and Slough).
To approve the Inter Authority Agreement for
Berkshire East that will authorise Bracknell Forest to lead the ISH
service procurement process for Berkshire East boroughs.
 

Decision

RESOLVED that
 

i.      
the Inter Authority Agreement for Berkshire East that will
authorise
Bracknell Forest to
lead the ISH service procurement process for Berkshire East
Boroughs is approved.
 

ii.    
the procurement of an ISH service under the new Contract
Standing
Orders (2024) and
under the Provider Selection Regime (2023) competitive process is
approved.
 

iii.   
the procurement for an initial term of 5 years (1 July 2026 –
30 June
2031) with two (2)
12-month optional extensions is approved.
 

iv.   
the delegation of authority to Bracknell Forest to undertake
the
procurement on
behalf of the three (3) Berkshire East boroughs (Bracknell Forest,
RBWM and Slough) is approved.
 

v.    
Authority be delegated to Bracknell Forest Executive Director of
Place in consultation with the Cabinet Member for Adults and Public
Health to award the contract to the successful bidder on behalf of
the three (3) Berkshire East boroughs (Bracknell Forest, RBWM and
Slough).

Reasons for the decision

i.      
The Local Authorities (Public Health Functions and Entry to
Premises by Local Healthwatch Representatives) Regulations 2013
require local authorities to provide or make arrangements to secure
the provision of open access sexual health services for everyone
present in their area. The procurement of this service is essential
for fulfilling this statutory duty and ensuring the ongoing
provision of sexual health services in compliance with national
guidelines and standards.
 

ii.    
Sexual Health Services (including the provision of contraception
and sexually
transmitted
infections testing and treatment) are prescribed functions under
the Public Health Grant conditions.
 

iii.   
The contract for the ISH service for residents in the local
authorities across Berkshire East (Royal Borough of Windsor and
Maidenhead Council (RBWM), Bracknell Forest Council and Slough
Borough Council) comes to an end of 30th June 2026.
 

iv.   
The PSR Regulations require that the PSR competitive process must
be followed when the relevant authority is not required to follow
direct award processes A or B, and the relevant authority cannot or
does not wish to follow direct award process C or the most suitable
provider process (for example, because it has not been able to
identify a most suitable provider or because it
wishes to test the market). In the Berkshire East
context:
 

·      
PSR Direct
Award Process A does not apply as there are alternative providers
in the market that could deliver this service.
 

·      
PSR Direct
Award Process B does not apply as there are not multiple
local
providers
and we intend to only contract one provider, so there is no choice
for service users.
 
·      
The PSR Direct Award Process C cannot be followed
because the “considerable change threshold” under the
PSR has been breached based on the following:
 
-  
the
lifetime value of the proposed new contract is £500,000
higher than the lifetime value of the existing contract when it was
entered into.

 
-  
the
lifetime value of the proposed new contract is 25% higher than the
original
lifetime value of the
existing contract when it was entered into.
 

v.    
Local Authority (LA) Chief Executives from Bracknell Forest, RBWM
and Slough requested the then East Berkshire Public Health Senior
Management Group to make recommendations on where the shared
functions should be dispersed.
 

vi.   
The Inter-Authority Agreement has been drafted to establish a
framework for the delivery of the relevant Public Health functions
and to clarify the Councils’
responsibilities.
 

vii.  
The relevant Public Health functions which are the subject to the
recommendations relating to the Inter-Authority Agreement are the
joint commissioning of Sexual and Reproductive Health Services and
support with specific elements of NHS health Checks delivery.
 
 

Alternative options considered

i.      
Option 1: Deliver the service as separate contracts. A lot approach could be used to procure the additional
elements outside of the integrated sexual health contract,including:
 

·      
Outreach service (targeting young people)

·      
Online testing provider
 
This option was not
taken because it would be more effective and cost-efficient to
include all service elements within a block contract.
 
A block contract
facilitates the movement of service users between different
elements of the service. This includes redirecting asymptomatic
patients who do not require in person appointments towards online
testing services, as well as enabling the follow up of complex
cases seen in the community clinics.
 
In addition, this
integrated approach allows for greater flexibility, freeing up
clinical time and resources to focus on delivering more complex
services within clinics and through outreach initiatives. This will
improve service reach and outcomes.
 
ii.    
Option 2: Deliver the service in-house. The Lead Authority (i.e.,
Bracknell Forest) takes full responsibility for the
delivery of the sexual health service. Staff, resources, and
management are retained within the council, and the service is
delivered directly to the public without outsourcing.
 
This
option was not taken because:
 
·      
Running a service in-house requires significant
financial, human, and technical resources, and the council bears
the full operational risks.
·      
The three (3) local authority lack the specialist
clinical knowledge, infrastructure and governance needed to deliver
complex sexual health services effectively.
 
iii.   
Option 3: Procure the service separately across
Berkshire East. Each Local Authority within Berkshire East procured
their own integrated sexual health service.

 
This
approach would not be favourable as it will result in significant
costs for all three (3) East boroughs (Bracknell Forest, RBWM, and
Slough) as it lacks economies of scale. This would be cost
inefficient for several reasons:
 
·      
Procuring separate services would require setting up
multiple sites or venues
across the
councils, significantly driving up expenses on facilities,
utilities, and
other
operational costs (e.g., administrative staffing and
management).
 
·      
Each authority would need its own council
commissioning and management teams, resulting in duplicated roles
and unnecessary spending on staffing.

 
·      
Commissioning services separately would prevent the
pooling of resources, risks and expertise, and sharing best
practices across the boroughs, leading to a lack of consistency,
compromised service quality and increased service cost.
 
·      
Procuring services independently limits negotiating
leverage, leading to potentially higher prices from suppliers and
service providers compared to a joint procurement.
 
iv.   
We also considered alternative routes to the market
within the PSR framework including undertaking direct award
processes.

 
·      
These alternative options were not taken because of
the reasons outlined in
Section
4.4.