Agenda item

[Report of the Interim Director of Public Health . To be introduced by the Cabinet Member for Adults and Health.]

The  report will seek an extension of the option to send the existing contract  as agreed by Cabinet for an additional 1+1 years for delivery of a dedicated Haringey young people sexual health and Women’s contraception services. The total contract term inclusive of the 1+1 year option to extend is 5 years.

The Cabinet Member for Adults and Health introduced this report which sought agreement from Cabinet to extend the existing Haringey Community Sexual Health services - Young People and Long Acting Reversible Contraception contract to Central and North West London NHS Foundation Trust. It sought to provide a community sexual health service focusing on young people’s sexual and reproductive health, comprising health promotion, testing and treatment for sexually transmitted infections (STIs) and access to contraception. The service also provided open access to Long Acting Reversible Contraception (LARC) methods for women of all age groups. 

The Cabinet Member highlighted that patient feedback from young people on the local dedicated service had been very positive. With 96% of patients attending the service responding that they were extremely likely or likely to recommend the service to someone, who needed similar care or treatment and 99% saying that the treatment and care they received was very good and also helped them achieve what mattered to them.

The Cabinet Member closed by noting that, given the positive performance indicators and feedback from the Council that these services had been operating successfully, the Cabinet Member was pleased to recommend that Cabinet extend the contract.

In response to a question from Councillor Palmer, Officers noted there were a range of different services available to all service users, including specialist providers for the Trans community. Councillor Palmer welcomed this but also noted it was important to engage with members of the Trans community to ensure inclusivity by asking what services were right for them.

RESOLVED

To agree to the extension of the contract to CNWL for the provision of Community Sexual Health services - Young People and Long Acting Reversible Contraception (LARC). As allowed under Contract Standing Orders 10.2.1 (b) for a period of up to 2 years from 3rd July 2020 to 2nd July 2022. The maximum value of the 2-year extension is £2,000,000, with a maximum contract value of £5,046,939 for the life of the contract.

Reasons for decision

In 2015/16, as part of the wider London sexual health transformation Programme, London Borough of Haringey initiated a review of locally commissioned services to scope their viability and effectiveness and ensure they were designed to meet the changing sexual health needs of local residents.

To gather a better understanding of the sexual and reproductive health needs of the Haringey population, the Council completed an Equality Impact Assessment (EQIA) and commissioned ‘Haringey Public Voice’ (Healthwatch) to conduct a survey on user experience relating to the existing services and to collate feedback on future models of service provision. The results showed that;

• A significant number of Haringey residents (primarily <25years and women) chose to access contraception and sexual health/sexual reproductive health (CaSH/SRH) services ‘in area’ in Haringey as opposed to choosing to go ‘out of area’ compared to neighbouring boroughs1. (EQIA - London Sexual health transformation Programme 2015). Out of a total of 17,400 attendances into CaSH services by Haringey residents in 2015/16 – 13600 attendances (78%) were through the locally commissioned service and 3800 attendances were ‘out of area’ (22%) (GUMCAD 2015/16).
• The Healthwatch survey demonstrated the importance of having a local service for current local users. The findings identified that;
  • The demographic data for the age group of those participating in the survey largely belonged to the 18-24 age group. The majority were female 72%, males 15%, transgender 1% and 12% providing no response.
  • Out of the range of multiple questions asked relating to service model, quality and delivery, the most frequently selected factor overall when it came to reasons for using the service was how close the clinic was to the patient’s home. (Haringey Public Voice Survey 2016)

Following the findings from the EQIA and Healthwatch survey, in September 2016 the Council undertook a full procurement exercise for a dedicated young people sexual health and women’s contraception service, inviting bids through the open Market. As a result of the procurement exercise, which was carried out in accordance with the Council’s Contract Standing Orders and the Procurement Code of Practice. The Council awarded the contract to CNWL for an initial period of 3 years with the option to extend for a further 2 years, subject to satisfactory performance and delivery of the contractual KPI’s by the successful tenderer (CNWL) as outlined in section 3 (above) in accordance with CSO 10.2.1 (b).

Alternative options considered

Prior to going out to Market, the Public Health team (as part of a scoping exercise) explored providing this service through the North Central London (NCL) sub regional tender process.

However, it was decided that as the NCL Genitor-Urinary Medicine GUM) contract would be based on a full clinical tariff and located outside Haringey this was not financially viable nor conducive to the needs of the service’s target audience i.e. young people and women. Instead, it was deemed more suitable to embed the service alongside the existing dedicated ‘step change’ community providers in Haringey to ensure a seamless pathway and collaborative approach towards young people and women’s health and wellbeing in the borough.

This decision was further strengthened by the equality impact assessment conducted via Healthwatch which identified that a large proportion of young people (under 25 years) and women preferred to access local services (see section 13 ‘Equalities’ for further information).

The Council has decided against retendering at this stage and is opting to extend because since tendering, there has been no new Market entrant that might offer a more cost effective service. From an access point of view, we are still in a position where we would not be able to merge the Haringey clinic into clinics in Islington and Camden and disrupting a relatively new service to vulnerable young people by changing providers would be detrimental and wasteful of resources.