Purpose

The report seeks approval to award the
Hammersmith & Fulham Genito Urinary Medicine (GUM) Sexual and
Reproductive Health service as part of the London Sexual Health
Programme to Chelsea and Westminster Foundation NHS Trust, to
commence on 5th August 2025 following a robust procurement process
under PSR 2023 Direct Award Process C. This service is a mandated
function under the Health and Social Care Act (2012), which
requires each local authority to provide, or secure the provision
of, open access sexual health services in its area including:
access to all types of contraception, preventing the acquisition
and transmission of sexually transmitted infections (STIs);
treating, testing and caring for people with STIs and partner
notification.

Decision

1.    
To note that Appendices 1 and 2 of this report are not for
publication on the basis that they contain information relating to
the financial or business affairs of any particular person (including the authority holding
that information) as set out in paragraph 3 of Schedule 12A of the
Local Government Act 1972 (as amended). 
 
2.    
To approve the award of a contract to Chelsea & Westminster
Foundation NHS Trust for the delivery of high-quality GUM Sexual
and Reproductive Health Services in Hammersmith & Fulham for an
initial term of two-years commencing 5th August 2025 to 4th August
2027, with an option to extend for up to two further periods of
two-years (‘2+2+2). The value of the initial two-year term is
£6,665,982 (£3,390,000 in the first year and
£3,275,982 in the second year), with a maximum value of
£18,569,734 (£2,975,938 per annum in subsequent years)
should all options to extend the contract be taken up and dependent
upon the annual ring-fenced Public Health Grant.
 

Reasons for the decision

1.    
Local Authorities are required to provide a range of Sexual and
Reproductive Health Services. The Health and Social Care Act (2012)
stipulates the mandated functions, which requires each local
authority to provide, or secure the provision of, open access
sexual health services in its area including: access to all types
of contraception; treating, testing and caring for people with
Sexually Transmitted Infections (STIs) and partner notification;
the provision of HIV Pre-Exposure Prophylaxis (PrEP), the preventative medication taken by HIV
negative individuals at greatest risk of getting HIV.
 
2.    
There is a lot of mobility around access, with many individuals
choosing to access services outside their area and therefore
pan-London arrangements and partnering agreements are in place to
support this arrangement. The London Sexual Health Programme (LSHP)
exists as a partnership of 30 London local authorities that
coordinates strategy and planning of sexual health services in the
capital and enables Hammersmith & Fulham to benefit from cost
effective tariffs for sexual health.
 
3.    
The City of London Corporation hosts the LSHP partnership and holds
the management function of the programme. The LSHP partnership is
in turn divided into sub-regions, with Hammersmith & Fulham
part of the Inner North West London
sub-region, comprising Westminster City Council as lead
commissioner and Royal Borough of Kensington and Chelsea. Each
member authority remains sovereign within this arrangement, with
the ability to end their own contracts.
 
4.    
The existing GUM contract expired on 31st March 2025. A short
extension of said contract with the incumbent provider was granted
to ensure compliance for 4 months to allow for the collaborative
Provider Selection Regime (PSR) process to be completed.
 
5.    
Under PSR legislation, commissioning authorities have the option to
directly award a contract to an incumbent provider if they are
satisfied with the performance, quality and value of the current
contract and are satisfied is likely to continue.
 
6.    
Commissioners from the Inner North West
London sub-region agree the CWFT are providing a service that
performs well, meets quality standards, demonstrates value for
money, and are satisfied that CWFT can deliver the new contract to
a sufficient standard against the five key criteria (further
information included in Appendix 1 and 2).
 
7.    
Following an evaluation of CWFT’s responses to both the key
and basic selection criteria, commissioners are confident that CWFT
successfully meets the requirements to deliver the proposed
contract to the expected standard.
 
 

Alternative options considered

1.    
Option 1: Do Nothing – not possible. This would mean
that when the current contract expires, the service would cease to
exist. The Local Authority has a statutory duty to commission open
access sexual health services, which is funded via ringfenced
Public Health grant fund.
 
2.    
Option 2: Continue to operate the current service under the
existing framework – not possible. The current framework
agreement was tendered for an initial 7 years and there is no
opportunity to extend for further years under the new PSR
regulations as the original framework agreement has now
expired.
 
3.    
Option 3: Competitive re-procurement process – not
recommended. This process is permitted under the new PSR
regulations; however, it has been agreed by commissioners that the
current provider is providing services to a high standard and a
full competitive process would not be a good use of public
funds.
 
4.    
Option 4: Most Suitable Provider process – not
recommended. Although this is a valid route under PSR regulations,
allowing direct award based on five key criteria, it is not
recommended as the absence of competition increases the risk of
challenge and less robust from a governance and transparency
perspective.
 
5.    
Option 5: Use of Direct Award Process C under the PSR
– Recommended.  
This requires a
two-stage test to be followed:
 
Test 1: 

(a) The relevant authority is not
required to follow Direct Award Process A or Direct Award Process
B. Satisfied. 

(b) The term of an existing contract
is due to expire, and the relevant authority proposes a new
contract to replace that existing contract at the end of its term.
Satisfied. 

(c) The “considerable
change” threshold is not met – See Test 2. 

(d) The relevant authority is of the
view that the existing provider is satisfying the existing contract
and will likely satisfy the proposed contract to a sufficient
standard. Satisfied. 

(e) The procurement is not to
conclude a framework agreement. Satisfied. 

 
Test 2: 
The considerable change threshold. If any of
the following apply, then the procurement would fail item (c) as
above, and could not follow Direct Award Process C. 

(a) The proposed contracting
arrangements must not be materially different in character to the
existing contract when that existing contract was entered into.
Satisfied. 

(b) Consideration of: 

changes in the relevant health care
services to which the proposed contracting arrangements relate
(compared with the existing contract) are attributable to a
decision of the relevant authority. 

the lifetime value of the proposed
contracting arrangements is at least £500,000 higher than the
lifetime value of the existing contract when that existing contract
was entered into. 

the lifetime value of the proposed
contracting arrangements is at least 25% higher than the lifetime
value of the existing contract when that existing contract was
entered into. 

 
The considerable change threshold is not met,
and with the other general tests being satisfied under Test 1,
Direct Award Process C can be used and is therefore
recommended.