Agenda item

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

Contract variation to the service which covers the need to implement new tariffs and align the contract to financial years, implementation of an addendum to the integrated sexual health specification in regards to commissioning responsibilities of PrEP  transferring to Local Authorities and other local service changes specific to Barnet, Camden & Islington.

The Cabinet Member for Adults and Health introduced the report which sought approval for a number of changes required within the North Central London (NCL) sexual health contract awarded to Central North West London NHS Foundation Trust and wider London partners, as part of ongoing service development, response to the impact of COVID on service provision and other service changes including responsibilities to deliver PrEP for the prevention of HIV.

In response to questions from Councillor Palmer, Dr Will Maimaris advised that the uptake of PrEP had not been as high as expected, however work was being undertaken to ensure that availability of PrEP would be communicated to those in the borough who required it.

RESOLVED

To approve the contract variation to the Central and North West NHS Trust contract for lots 1a - Genito-Urinary Medicine (GUM) services to enable the following contract variations to be implemented;

1.      Introduction of new activity baseline for Rest of London (RoL) for 2020/21

2.      As set out in paragraphs 6.5.1 and 6.5.2, to agree the annual lump sum payment of £218,402 to Haringey council for routine PrEP commissioning.

3.         A change to service level at the Barnet clinic and some one-off investment spend to support patient access.

4.         Implementation of new and changed tariffs for sexual and reproductive services delivered across London.

5.         One off investment in 2019/20 to CNWL by London Boroughs of Camden and Islington for localised sexual & reproductive health initiatives.

Reasons for decision

The contract variation required in this report is specific to Lot 1a and forms the wider variation to the service contract which covers the need to revise CNWL baseline activities for RoL, implement new and changed tariffs, align the contract to financial years which was discussed and agreed by NCL commissioners and CNWL and make provision for the funding of PreP service via local authorities.

The NCL Integrated Sexual Health (NCLISH) services are provided by Central and North West London NHS Foundation Trust (CNWL).

The Haringey lot 1a - Genito-Urinary Medicine (GUM) contract for clinic based services commenced on 3 July 2017, in partnership with Barnet, Camden & Islington for a period of five (5) years (with an option to extend for a further 3 years on contract extensions of one (1) year each).  For Haringey, the initial 5-year contract term is estimated to cost £7,963,771 million. Adding the option to extend the contract for 3 further periods of one year each at an estimated cost of £1,608,073 million for each of these years brings the maximum total estimated cost of the contract to £12,787,991 million.

Pre Exposure Prophylaxis (PreP) funding allocation has been approved and was transferred to Local Authorities October 2020. For Haringey, the annual value will be £218,402.

Alternative options considered

This is a mandated open access service. Service transformation has already realised significant savings and transferred the previous sexual health services into an integrated system across the NCL sector. This is an activity and tariff based contract, and therefore charges are ultimately based on levels of activity. Due to the complex nature of the cross charging arrangements, this service is part of the London Sexual Health Programme (LSHP).

The Memorandum of Understanding (MOU) for the LSHP strategic board sets out that partners agree to a number of areas of working together “collaboratively regarding the Integrated Sexual Health Tariff (ISHT). As part of the LSHP, it is required that services use a standardised contract format agreed by all Boroughs as part of the governance of the transformation. This ensures that all the clinics are governed under a similar set of terms and conditions, as a result, any changes made to the contract need to be made in agreement with colleagues across London, in accordance to the contract clause.