Purpose

Proposed decision.
 

APPROVE the
commissioning arrangements and continued contracting with primary
care via a procurement compliant process for the delivery of
Long-Acting Reversible Contraception, from 1 December 2026 up to no
later than 31 March 2033.

 

DELEGATE authority to the Director of Public Health to undertake
all necessary actions to implement the decision, including, but not
limited to, awarding new contracts, finalising terms, entering
into contracts, initiating extensions, formalising variation
and establishing any required legal agreements.

 
Reason for the decision
 
Kent County Council
(KCC) has a statutory duty to provide reasonable access to a broad
range of contraceptive substances and appliances as per Section 6
of The Local Authorities (Public Health Functions and Entry to
Premises by Local Health Watch Representatives) Regulations
2013.
 
Unplanned pregnancies
are significant contributors to poor health outcomes, and provision
of the LARC service plays an important role in reducing the
negative consequences and costs of it. Continuing to commission
LARC through primary care offers advantages in terms of
accessibility, convenience, patient choice, comprehensive care, and
cost-effectiveness.
 
The current
Long-Acting Reversible Contraception (LARC) Service in Primary Care
contract is due to end on 30 November 2026. To ensure continuity of
service, new contracts are required for the delivery within primary
care.
 
 
Background
 
Long-Acting Reversible
Contraception (LARC) is a clinically effective and cost-efficient
contraception method, currently delivered via integrated sexual
health services and primary care providers. All practitioners
providing the commissioned service have achieved a relevant Letter
of Competence issued by College of Sexual and Reproductive Health
(CoSRH).
 
The service provides
LARC fitting and removal procedures to women who opt to use these
methods to prevent pregnancy. Approximately 11,000 LARC procedures
are performed annually in primary care settings (currently 102
practices) across Kent.
 
Options (other options considered but discarded)
 

1.  
Cease commissioning through primary
care - discarded due to reduced
accessibility and increased pressure on integrated specialist
services.

 

2.  
Commission via a single provider
model - discarded due to lack of
flexibility and geographic coverage.

 

3.  
Continue commissioning directly from
multiple primary care providers via a
Direct Award B (as per Procurement Act 2023) - preferred for
accessibility and continuity.
 
The proposal is to
continue commissioning LARC directly from multiple primary care
providers via a Direct Award B (as per Procurement Act 2023)
process. The recommendation is to maintain and strengthen these
services, ensuring the council meets its statutory
obligation.
 
 Benefits of this approach include:

-     
Good geographical coverage across the county
ensuring equitable service, as the same service is available
regardless of geographical area in the county.

-     
Fostering accessibility and patient
choice.

-     
The commissioning authority remains close to the
communities, able to respond to local needs.

-     
Direct assurance of each provider’s competence
which supports good quality and safety of the service.

-     
Maintaining control and access to service data and
ability to audit performance.

-     
Flexibility for GP practices to contract on behalf
of other practices to improve access.

-     
Value for money benefits demonstrated by the public
health outcomes and the resulting return on investment to the wider
system.
 
How the proposed decision supports the

Framing Kent's Future - Our
Council Strategy 2022-2026
 
This service
contributes to ‘Priority 1: Levelling up Kent’ of the
Framing Kent’s Future Our Council Strategy 2022-2026 as
providing contraception to women can prevent unplanned pregnancies,
which is a preventative approach of improving the populations
health and narrowing health inequalities.
 
This approach aligns
with
Securing Kent’s Future -
Budget Recovery Strategy and
the council’s Best Value Statutory responsibility, as this
decision prioritises best value considerations. This is a
preventative service with evidence of good Return on Investment and
can help reduce demand into other KCC services and across the
health and social care system.
 
Locally, the provision
of the services supports the
Kent and Medway
Integrated Care Strategy, supporting its ‘Shared Outcome 4: Empower
People to Best Manage their Health Conditions’ and
delivers the recently published
Kent Sexual Health Needs
Assessment 2024.
 

Decision

As Cabinet Member for Adult Social Care and
Public Health, I agree to:
 

APPROVE the re-commissioning arrangements and continued contracting
with primary care via a procurement compliant process for the
delivery of Long-Acting Reversible Contraception. The new contract
will commence on 1 December 2026 for an initial period of four
years and four months, with the option to extend for up to two
additional one-year periods, ending no later than 31 March
2033.

 

DELEGATE authority to the
Director of Public Health to undertake all necessary actions,
including, but not limited to awarding contracts, finalising terms,
entering into
legal agreements, and making  any
necessary refinements to the commissioning strategy over the life
of the contract as described to implement the decision, providing
they do not require additional governance.

 

DELEGATE authority to the
Director of Public Health, in consultation with the Cabinet Member
for Adult Social Care and Public Health to utilise the relevant
contract extensions