Agenda item

Report of the Corporate Director of Adults, Housing and Health. To be presented by the Cabinet Member for Health, Social Care and Wellbeing.

DECLARATIONS OF INTEREST MADE FOR THIS ITEM:

None

RESOLVED:

That Cabinet, as permitted under CSO 18.03 and in accordance with CSO 2.01(d):

1. Approved the variation of terms to allow the extension of the Council's existing IAA with the City of London for access to the pan-London online sexual health service for a period of 12 months from 15 August 2026, with an option to extend for a further period of 12 months.
   
   
2. Approved the estimated value of £620,000 for 12 months and a total value of £1,240,000 for 24 months. The aggregated total spend by the Council, including the proposed variation and extension, would be £4,775,776 excluding VAT.
   
   

Reasons for Decision

The Council's existing IAA for accessing the pan-London Online Sexual Health Service expired on 14 August 2026. The proposed extension was necessary to ensure that the Council could continue to access the service while a new contract was put in place by the City of London.

The City of London had undertaken a competitive procurement process for a new nine-year contract, due to commence on 15 August 2026. However, the procurement had not progressed as anticipated and the City of London intended to issue a 12-month extension to the current contract. The standstill period for the future provision of the online sexual health service had not yet concluded following a challenge to the contract award outcome by an unsuccessful bidder and the need for the City of London to complete the remaining procurement assurance processes. As a result, the new contract could not be awarded and mobilised before the expiry of the current contract on 14 August 2026.

This was an activity-based contract. The current contract had been commissioned by the City of London through a competitive process involving 31 other London boroughs. The City of London had negotiated competitive rates under the original tender, and those rates would continue if the contract was varied and extended for a further 12 months.

Haringey Council was part of the pan-London e-service management board overseeing contract performance and governance. The provider had consistently met contract performance indicators throughout the lifetime of the contract, including targets for the dispatch of testing kits and processing times. The service had continued to evolve in response to service user and commissioner feedback, and changes in clinical guidelines. The provider also had robust safeguarding measures in place.

Alternative Options Considered

Option 1: Do Nothing

The Council could have chosen not to extend the contract and allowed it to expire. However, this option would have presented a number of significant risks, including reputational and financial risks to the Council:

• Complete loss of digital access to sexual health services.
• Increased expenditure on more expensive face-to-face clinic provision.
• Increased pressure on in-person services.
• Reputational risk arising from the loss of accessible health services.
• Increased risk of health inequalities.
  
  

Option 2: Insource or Commission Services Independently

The Council could have decided not to extend the pan-London e-service Inter-Authority Agreement and instead commission a separate service through the Provider Selection Regime for health services. However, this was not considered a viable option because the Council would have:

• Lost access to a coordinated London-wide service.
• Failed to align with the North Central London sub-regional Integrated Sexual Health strategic service provision.
• Potentially incurred significantly higher costs due to the loss of economies of scale.
• Risked service fragmentation and reduced accessibility for service users.
  
  

Therefore, this option was not recommended.

The Cabinet Member for Health and Social Care introduced the report.

The Cabinet Member explained that the proposals were for a time-limited extension to the existing Inter-Authority Agreement for the pan-London online sexual health service, ensuring that residents continued to have access to sexual health support while the procurement process for a replacement service was completed.

It was stressed that sexual and reproductive health was recognised as an important component of the health and wellbeing of Haringey residents. Access to testing, contraception, treatment and advice contributed to the prevention of ill health, reduced transmission of sexually transmitted infections and supported the prevention of unplanned pregnancies. Access to sexual health services was also recognised as an important factor in addressing health inequalities, particularly for people living in more deprived communities, young adults, LGBTQ+ residents, some ethnic minority communities, and individuals who experienced barriers associated with stigma, discrimination, disability or concerns about confidentiality.

Haringey had invested in a range of sexual health services, including dedicated clinics for young people, local access to long-acting reversible contraception through council clinics and general practices, outreach services for diverse communities, provision through Healthy Living pharmacies, and an integrated sexual health service commissioned jointly with neighbouring boroughs. The pan-London online service complemented these local services by providing home testing and contraception for residents aged 16 and over, while directing individuals with symptoms, safeguarding concerns or more complex needs to appropriate face-to-face services. For some residents, online provision improved accessibility to sexual health services.

The service had been accessed by residents from a range of backgrounds, including those experiencing health inequalities. During 2024/25, more than half of postal testing kit orders were made by residents living in the four most deprived deciles. The service was also used by residents from ethnically diverse communities, LGBTQ+ residents and people across different age groups. This was particularly relevant given the comparatively high level of sexual health need within the borough, including sexually transmitted infection diagnosis rates above both London and national averages.

The Cabinet Member explained that the pan-London service had originally been procured through a competitive tender process led by the City of London on behalf of participating London boroughs and had been awarded to Preventx Limited. A subsequent competitive procurement process for a successor service had been undertaken; however, completion of the process had been delayed following a challenge to the contract award by an unsuccessful bidder and the need to complete remaining assurance processes. Cabinet was therefore asked to approve a time-limited extension of the existing Inter-Authority Agreement to maintain service continuity while the procurement process was concluded. This approach was intended to maintain continuity of care, preserve patient choice and support equitable access to sexual health services.

Following questions from Councillors Beckford the following information was shared:

• It was explained that over 22,000 utilised the services, noting that they provided a discrete care service. It was additionally noted that the service utilisation was reflective of Haringey’s diversity.

RESOLVED:

That Cabinet, as permitted under CSO 18.03 and in accordance with CSO 2.01(d):

1. Approved the variation of terms to allow the extension of the Council's existing IAA with the City of London for access to the pan-London online sexual health service for a period of 12 months from 15 August 2026, with an option to extend for a further period of 12 months.
   
   
2. Approved the estimated value of £620,000 for 12 months and a total value of £1,240,000 for 24 months. The aggregated total spend by the Council, including the proposed variation and extension, would be £4,775,776 excluding VAT.
   
   

Reasons for Decision

The Council's existing IAA for accessing the pan-London Online Sexual Health Service expired on 14 August 2026. The proposed extension was necessary to ensure that the Council could continue to access the service while a new contract was put in place by the City of London.

The City of London had undertaken a competitive procurement process for a new nine-year contract, due to commence on 15 August 2026. However, the procurement had not progressed as anticipated and the City of London intended to issue a 12-month extension to the current contract. The standstill period for the future provision of the online sexual health service had not yet concluded following a challenge to the contract award outcome by an unsuccessful bidder and the need for the City of London to complete the remaining procurement assurance processes. As a result, the new contract could not be awarded and mobilised before the expiry of the current contract on 14 August 2026.

This was an activity-based contract. The current contract had been commissioned by the City of London through a competitive process involving 31 other London boroughs. The City of London had negotiated competitive rates under the original tender, and those rates would continue if the contract was varied and extended for a further 12 months.

Haringey Council was part of the pan-London e-service management board overseeing contract performance and governance. The provider had consistently met contract performance indicators throughout the lifetime of the contract, including targets for the dispatch of testing kits and processing times. The service had continued to evolve in response to service user and commissioner feedback, and changes in clinical guidelines. The provider also had robust safeguarding measures in place.

Alternative Options Considered

Option 1: Do Nothing

The Council could have chosen not to extend the contract and allowed it to expire. However, this option would have presented a number of significant risks, including reputational and financial risks to the Council:

• Complete loss of digital access to sexual health services.
• Increased expenditure on more expensive face-to-face clinic provision.
• Increased pressure on in-person services.
• Reputational risk arising from the loss of accessible health services.
• Increased risk of health inequalities.
  
  

Option 2: Insource or Commission Services Independently

The Council could have decided not to extend the pan-London e-service Inter-Authority Agreement and instead commission a separate service through the Provider Selection Regime for health services. However, this was not considered a viable option because the Council would have:

• Lost access to a coordinated London-wide service.
• Failed to align with the North Central London sub-regional Integrated Sexual Health strategic service provision.
• Potentially incurred significantly higher costs due to the loss of economies of scale.
• Risked service fragmentation and reduced accessibility for service users.
  
  

Therefore, this option was not recommended.