Purpose

Re-commissioning the service allows continued wider access to evidence-based drug harm reduction interventions, thereby:

-        Decreasing risk of transmission of blood-borne infections associated with using non-sterile injecting equipment

-        Decreasing risk of illicit drug related deaths

-        Decreasing risk of injury and infections spread from discarded used injecting equipment

-        Ensuring universal access to drug harm reduction interventions, helping to reduce inequalities in access for underserved and vulnerable populations

-        Helping people to achieve recovery from drug use

-        Supporting fulfilment of local and national strategic actions to prevent harms and deaths from drug use

Decision

The decision is to re-commission the contract for provision of Needle Exchange Delivery and Waste Collection and Disposal (NXDWC) service.

Needle Exchange service provides sterile injecting equipment and other drug harm reduction products to people who use drugs. The service also enables collection and safe disposal of drug injecting waste.

The aim of a Needle Exchange service is to prevent blood-borne infections and other harms associated with illicit drug use. The service is available locally from Oxfordshire County Council approved outlets.

The NXDWC contract relates to the supply of injecting equipment to these Council approved outlets and the collection and safe disposal of injecting waste returned to the outlets by users.

The contract is commissioned by Public Health; the current contract commenced on 1st April 2022 and ends on 31st March 2027

The decision is to commission a new contract for the service, for a 3-year, plus 4, term, starting from 1st April 2027.

The proposed budget for the contract is approximately £48,000 per year, whole life cost of circa £336,000.

Reasons for the decision

To proceed to the next stage of the Provision Cycle

Alternative options considered

1)    Do Nothing Option – this option is to cease provision of the service after the current contract ends. This would in turn result in cessation of the interdependent harm reduction services thereby: increasing the risk of injury and infections among people who use drugs and the wider population; increasing the risk of death from drug use; increasing demand on other health, social and wider public services due to increased risk of harms associated with reduced access to drug harm reduction interventions.

2)    Bring service in-house. The NXDWC contract is a specialist product-supply service as well as a sharps waste collection service. It is difficult to see how the product-supply element of the contract can be delivered in-house so this option would require procuring this element of the contract. The value of the waste collection element of the contract is relatively small. The current format of combining the product-supply and waste collection elements has been cost- and service efficient for the Council. It also works well for outlets. Changing the new contract to separate the waste collection element is not likely to lead to any savings or better value for money. This option has also been explored with other parts of the Council and with the NHS/national frameworks and was found to not be cost- or service- efficient.