Purpose

A contract variation order to provide a
financial uplift to the Axess Sexual Health Service for the
remainder of the current contract, to meet the costs of new
Pre-Exposure Prophylaxis technologies; new Doxycycline post
exposure prophylaxis prescriptions; and the integration of
Tuberculosis screening alongside sexual health blood-borne virus
testing.

Decision

For the reasons set out in this report, the
Director has decided to:
 
1)   
Approve the variation of the existing Integrated Sexual Health
Service contract (Axess DN517038)
between the Council and Liverpool University Hospitals NHS
Foundation Trust (LUHFT) for the remainder of the initial term of
the contract (1st May 2025 - 31st October 2026) in accordance with
the current 
terms of the contract. The current contract value is
£6,478,689.95. The variation value will be £249,000 per
annum.
 
2)   
The variation will be funded via the Public Health ring-fenced
grant on a recurrent basis.

Alternative options considered

Option 1: Do nothing - This would result in
significant financial pressure for LUHG to continue to deliver the
recommended STI and HIV prevention services to residents and the
groups outlined. It would also be a missed opportunity to
strengthen TB prevention and control through the integration of TB
testing into the existing Axess
service. Given the lack of tangible benefits in doing so, this
option was not chosen.
 
Option 2: Vary the existing contract for the
provision of doxyPEP and HIV
PrEP with the contracted provider, but procure a TB prevention and control
service separately. This was rejected as there is already a TB
prevention and control service in place, and they offer TB testing
and confirmatory testing and do not have capacity to deliver the
broader latent TB screening programme (which is currently already
delivered by LUHFT)