Purpose

To approve the strategic procurement plan for GP Long-Acting Reversible Contraception

(LARK) and NHS Health Checks across Berkshire East (Bracknell Forest, Slough and the Royal Borough of Windsor and Maidenhead), funded through the dedicated Public Health Grant, using the Provider Selection Regime (PSR) Direct Award Process B, in accordance with the Inter-Authority Agreement.

Decision

RESOLVED that Cabinet

·       APPROVES the strategic procurement plan for GP LARC and NHS Health Checks across Berkshire East (Bracknell Forest, Slough and the Royal Borough of Windsor and Maidenhead), funded through the dedicated Public Health Grant, using the Provider Selection Regime (PSR) Direct Award Process B, in accordance with the Inter-Authority Agreement.

·       APPROVES the delegation of authority, in consultation with the Cabinet Member for Children, Young People, Health, Adults, and Public Health, to the Executive Director of Place in Bracknell Forest Council to award the contracts both in the initial round of applications and any future applications that may be received during the contract lifecycle.

Reasons for the decision

NHS Health Checks are a statutory service and form part of the mandatory prescribed functions under the Public Health Grant. LARC services are non-prescribed, evidence-based preventative service that improve reproductive health outcomes, reduce unintended pregnancies, contribute to reducing health inequalities, and help avoid future demand on health and social care services.

It provides a proportionate and efficient route to market where the existing providers are able to demonstrate satisfactory performance and the ability to continue delivering high-quality services.

It supports continuity of service provision for residents, helping to avoid disruption to access, patient pathways and established referral arrangements.

Existing GP providers already have the clinical infrastructure, workforce and local knowledge required to deliver both services effectively within primary care settings.

Alternative options considered

Option 1: Deliver the service in-house. Bracknell Forest Council takes full responsibility for the delivery of the services. Staff, resources, and management are retained within the council, and the service is delivered directly to the public without outsourcing.

This option is not recommended because:

·       Running a service in-house requires significant financial, human, and technical resources, and the council will bear the full operational risks. This will be more a more costly / less cost-effective solution for the council.

·       Bracknell Forest Council lacks the specialist knowledge, infrastructure and governance needed to deliver LARC and NHS Health Checks services safely and effectively.

Option 2: Each local authority takes responsibility for commissioning their own LARC and NHS Health Check services.

This option is not recommended because it will require significant costs for all three councils as it lacks economies of scale. This would be cost inefficient for several reasons:

·       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 with GP practices, leading to potentially higher tariff prices.

Option 3: To procure the services as a single contract.

This option is not recommended because:

·       Different criteria apply to the delivery of each service, including distinct service specifications, performance measures, target cohorts and reporting requirements.

·       NHS Health Checks and LARC services require different clinical expertise, operational models and provider experience, which may limit the number of organisations able to deliver both services effectively under one contract.

·       A single contract may also reduce flexibility for the Council to manage, review or redesign each service independently in response to changing local need or national policy.

Option 4: Do not commission a service/intervention.

This option is not recommended because:

·       NHS Health Checks are a one of the mandatory prescribed functions under the Public Health Grant conditions. NHS Health Checks aim to identify early signs of stroke, kidney disease, heart disease, type 2 diabetes and dementia, and to support residents to reduce their risk of developing these conditions through early intervention and lifestyle advice. Not commissioning this service would mean the Council would be unable to meet its statutory responsibilities.

·       LARC services are one of the non-prescribed functions under the Public Health Grant conditions.  These services are an important part of the prevention agenda, providing access to safe and effective contraception, supporting reproductive choice, reducing unintended pregnancies and improving wider sexual and reproductive health outcomes.