Decision Maker: Cabinet

Outcome: Recommendations Approved

Is Key Decision?: Yes

Is Callable In?: Yes

Date of Decision: April 29, 2025

Purpose: The purpose of this report is to outline the procurement process for commissioning the Integrated Sexual Health (ISH) services across Berkshire East (Bracknell Forest Council, Royal Borough of Windsor and Maidenhead, and Slough Borough Council), which will start from 1 July 2026, and seek approval for the following: To approve the procurement of an ISH service under the new Contract Standing Orders (2024) and under the Provider Selection Regime (2023) competitive process. To approve the procurement for an initial term of 5 years (1 July 2026 – 30 June 2031) with two (2) 12-month optional extensions. To approve the delegation of authority to Bracknell Forest to undertake the procurement on behalf of the three (3) Berkshire East boroughs (Bracknell Forest, RBWM and Slough) To approve the delegation of authority to Bracknell Forest Executive Director of Place to award the contract to the successful bidder on behalf of the three (3) Berkshire East boroughs (Bracknell Forest, RBWM and Slough). To approve the Inter Authority Agreement for Berkshire East that will authorise Bracknell Forest to lead the ISH service procurement process for Berkshire East boroughs.  

Content: RESOLVED that   i.       the Inter Authority Agreement for Berkshire East that will authorise Bracknell Forest to lead the ISH service procurement process for Berkshire East Boroughs is approved.   ii.     the procurement of an ISH service under the new Contract Standing Orders (2024) and under the Provider Selection Regime (2023) competitive process is approved.   iii.    the procurement for an initial term of 5 years (1 July 2026 – 30 June 2031) with two (2) 12-month optional extensions is approved.   iv.    the delegation of authority to Bracknell Forest to undertake the procurement on behalf of the three (3) Berkshire East boroughs (Bracknell Forest, RBWM and Slough) is approved.   v.     Authority be delegated to Bracknell Forest Executive Director of Place in consultation with the Cabinet Member for Adults and Public Health to award the contract to the successful bidder on behalf of the three (3) Berkshire East boroughs (Bracknell Forest, RBWM and Slough).

Reasons for the decision: i.       The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013 require local authorities to provide or make arrangements to secure the provision of open access sexual health services for everyone present in their area. The procurement of this service is essential for fulfilling this statutory duty and ensuring the ongoing provision of sexual health services in compliance with national guidelines and standards.   ii.     Sexual Health Services (including the provision of contraception and sexually transmitted infections testing and treatment) are prescribed functions under the Public Health Grant conditions.   iii.    The contract for the ISH service for residents in the local authorities across Berkshire East (Royal Borough of Windsor and Maidenhead Council (RBWM), Bracknell Forest Council and Slough Borough Council) comes to an end of 30th June 2026.   iv.    The PSR Regulations require that the PSR competitive process must be followed when the relevant authority is not required to follow direct award processes A or B, and the relevant authority cannot or does not wish to follow direct award process C or the most suitable provider process (for example, because it has not been able to identify a most suitable provider or because it wishes to test the market). In the Berkshire East context:   ·       PSR Direct Award Process A does not apply as there are alternative providers in the market that could deliver this service.   ·       PSR Direct Award Process B does not apply as there are not multiple local providers and we intend to only contract one provider, so there is no choice for service users.   ·       The PSR Direct Award Process C cannot be followed because the “considerable change threshold” under the PSR has been breached based on the following:   -   the lifetime value of the proposed new contract is £500,000 higher than the lifetime value of the existing contract when it was entered into.   -   the lifetime value of the proposed new contract is 25% higher than the original lifetime value of the existing contract when it was entered into.   v.     Local Authority (LA) Chief Executives from Bracknell Forest, RBWM and Slough requested the then East Berkshire Public Health Senior Management Group to make recommendations on where the shared functions should be dispersed.   vi.    The Inter-Authority Agreement has been drafted to establish a framework for the delivery of the relevant Public Health functions and to clarify the Councils’ responsibilities.   vii.   The relevant Public Health functions which are the subject to the recommendations relating to the Inter-Authority Agreement are the joint commissioning of Sexual and Reproductive Health Services and support with specific elements of NHS health Checks delivery.    

Alternative options considered: i.       Option 1: Deliver the service as separate contracts. A lot approach could be used to procure the additional elements outside of the integrated sexual health contract,including:   ·       Outreach service (targeting young people) ·       Online testing provider   This option was not taken because it would be more effective and cost-efficient to include all service elements within a block contract.   A block contract facilitates the movement of service users between different elements of the service. This includes redirecting asymptomatic patients who do not require in person appointments towards online testing services, as well as enabling the follow up of complex cases seen in the community clinics.   In addition, this integrated approach allows for greater flexibility, freeing up clinical time and resources to focus on delivering more complex services within clinics and through outreach initiatives. This will improve service reach and outcomes.   ii.     Option 2: Deliver the service in-house. The Lead Authority (i.e., Bracknell Forest) takes full responsibility for the delivery of the sexual health service. Staff, resources, and management are retained within the council, and the service is delivered directly to the public without outsourcing.   This option was not taken because:   ·       Running a service in-house requires significant financial, human, and technical resources, and the council bears the full operational risks. ·       The three (3) local authority lack the specialist clinical knowledge, infrastructure and governance needed to deliver complex sexual health services effectively.   iii.    Option 3: Procure the service separately across Berkshire East. Each Local Authority within Berkshire East procured their own integrated sexual health service.   This approach would not be favourable as it will result in significant costs for all three (3) East boroughs (Bracknell Forest, RBWM, and Slough) as it lacks economies of scale. This would be cost inefficient for several reasons:   ·       Procuring separate services would require setting up multiple sites or venues across the councils, significantly driving up expenses on facilities, utilities, and other operational costs (e.g., administrative staffing and management).   ·       Each authority would need its own council commissioning and management teams, resulting in duplicated roles and unnecessary spending on staffing.   ·       Commissioning services separately would prevent the pooling of resources, risks and expertise, and sharing best practices across the boroughs, leading to a lack of consistency, compromised service quality and increased service cost.   ·       Procuring services independently limits negotiating leverage, leading to potentially higher prices from suppliers and service providers compared to a joint procurement.   iv.    We also considered alternative routes to the market within the PSR framework including undertaking direct award processes.   ·       These alternative options were not taken because of the reasons outlined in Section 4.4.