Purpose

The Council has a statutory duty to arrange and fund medical assessments for adoption, fostering and SGOs. The medical assessment service in Lincolnshire, current delivered by ULTH, supports the Council in its statutory duty which ensures children and prospective carers involved in adoption, fostering, and SGOs receive appropriate health evaluations to support safe
and timely permanency planning. However, ULTH has previously been delivering the service without funding from the Council which is no longer a sustainable model. The Council commissioned service will deliver the core
functions of Child physical medicals, review of adult medical assessments, and the Medical Advisor role. The Council’s funding will support the cost of 1.0 whole time equivalent (WTE) Specialty Registrar and 1.0 WTE administrator for the medical assessments and related activity. The contract would be as an interim measure whilst a commissioning review is undertaken.

The contract will be procured through the Provider Selection Regime (PSR), which is a procurement of services as listed under the CPV codes contained in Schedule 1 of the Health Care Services (Provider Selection Regime) Regulations 2023 (PSR Regulations 2023). PSR is allowed for within the
Council’s Contract and Procurement Procedure Rules (CPPR) and is also compliant with the Procurement Act 2023.

Decision

To directly award, through the Provider Selection Regime, a
contract to United Lincolnshire Teaching Hospitals NHS Trust
(ULTH) for the provision of a Medical Assessment Service for
Adoption, Fostering and Special Guardianship Orders (SGOs)
as an interim arrangement whilst a commissioning review is
undertaken.
The contract will be for 12 months initially and will commence
from 1st April 2026 to 31st March 2027, with an option to
extend for a further 12 months from 1st April 2027 to 31st
March 2028.
The annual value of the contract will be £181,950 per annum
(excluding VAT).
The overall maximum value should the 12-month extension be
realised will be £363,900 (excluding VAT).

Alternative options considered

Do Nothing: This was not a viable option. The Council has
statutory obligations it must meet for adoption and fostering
processes.

Commission ULTH to provide Child Physical Medicals Only: This
was not considered a viable option as it would not meet
statutory requirements for adoption and fostering processes.
The procurement of a separate provider for the Medical Advisor
role would incur additional costs to the Council and would not
result in best value for money for children and their families.
Splitting responsibilities between different providers would also
fragment the pathway and negatively impact on the continuity
of provision for families.

Commission or Directly Employ a Medical Advisor (in addition
to ULTH Medical Assessments): This was not the preferred
option. Benchmarking has shown there is a limited and
uncertain market for standalone Medical Advisor roles and
separating child medicals and the Medical Advisor function
would risk fragmentation of the service for children and
families.

Deliver a Council-led Medical Assessment Service: This was not
the preferred option. Recruiting and retaining suitably
experienced medical professionals for a dedicated in-house
service would present challenges for the Council to build the
clinical infrastructure to support these roles which may be more
expensive.