Agenda item

To provide an update on the procurement programme for a new NHS 111 Integrated Urgent Care service to commence in October 2023.

Clare Kapoor, an NHS 111 commissioner with the NCL ICB and a nurse by background, introduced the report for this item explaining that the current NHS 111 Integrated Urgent Care Service (IUC) contract had been extended but was due to end in October 2023 which meant there was about a year left to procure and get ready for the new service.

She explained that the procurement for the new contract was overseen by a multi-disciplinary Procurement Steering Group. There were two sub-groups, one of which was clinical and the other for engagement and communications which included residents and patient/user group representatives. The procurement process had recently moved from phase 1 (Planning) to phase 2 (Procurement) and would later be followed by phase 3 (Mobilisation). Bidders would shortly be invited to tender and the timeline was set out in the report.

The existing service included the NHS 111 telephone and online support, urgent GP face-to-face services and a clinical assessment service. The new service would add to this with enhancements including direct booking of patients into services such as primary care appointments or referrals into same day emergency care. There were greater opportunities to treat and manage patients within the service where appropriate, for example by prescribing medication.

In terms of engagement, there had been an online survey carried out, community groups in each of the Boroughs had been contacted and HealthWatch in Enfield had been commissioned to run focus groups and had worked with groups where English was not their first language. The feedback had been used to develop an action plan and to help shape the service specification.

Rod Wells from Haringey Keep Our NHS Public asked why a competitive tendering process was necessary as he understood that this was no longer required under the new Health and Social Care Act. Clare Kapoor clarified that the new rules had not yet come into force and, as there wasn’t much time before the existing contract was due to come to an end, the legal advice received had been to go ahead with the procurement process as outlined in the report. In future, there could be scope to directly award contracts such as this based on certain criteria.

Cllr Atolagbe asked how, with the current contract due to end soon, how there would be continuity in training and how the feedback on accessibility would be addressed. Clare Kapoor explained that training requirements were part of a suite of documents for the procurement on the contract portal which also included the patient feedback and the Equality Impact Assessment. The service specification included a section on accessibility for different patient groups. There had recently been a training video produced for NHS111 on handling callers with a learning disability and also a video produced for the deaf community to explain how they can access the service.

Cllr Clarke asked how much the contract was worth and whether NHS organisations could bid for it. Clare Kapoor said that the current provider, a social enterprise called LCW, had been in place for around 9 or 10 years and that the current value of the contract was around £19m per year to deliver the whole service. This was regularly kept under review and was overseen by NHS England. For example, there had been a 57% surge in calls during the Covid-19 pandemic, so it had been necessary to review the service provision. The contract value was expected to remain at around the same level. Cllr Clarke asked why the contract value was not being raised given that there were extra elements of the service being delivered such as the London Ambulance Service integration work. Clare Kapoor said that this was a one-year pilot and that an evaluation was being awaited so it could come back into the contract in future. She said that NHS organisations could bid for the contract if they could deliver the call handling side. There could potentially be various different providers for different elements of the service or a single organisation delivering the whole contract as was currently the case.

Asked by Cllr Iyngkaran what provisions were in place for callers with mental health conditions, Clare Kapoor noted that there was a mental health champion on the patient engagement group so there had been some very good input. She added that there was a link between NHS111 and the mental health crisis hubs so there was an existing pathway. The recent feedback received had been given to NHS England and there was also a London mental health programme looking at how better to manage a range of mental health calls and on how to introduce mental health expertise earlier in the pathway. This could potentially be built into the new service.

The Committee then made the following recommendations (ACTION):

• Noting that much of the feedback about the call menu had been that it was too complicated/confusing, the Committee recommended that, once the new specification had been put in place, that the updated core menu should be tested with service users before it goes live.
• The Committee noted that the new contract for the NCL NHS 111 Integrated Urgent Care Service would have additional service requirements added to it but with no apparent uplift to the value of the contract. The Committee expressed concern that the provider would be required to deliver a more extensive service without an increase in funding and requested further explanation on how this would be achieved while maintaining service quality.