Agenda item

To receive a report on the re-procurement of the 111 Out of Hours Service. 

The Board received a report from Clare Kapoor, North Central London Urgent Care Programme Manager, on the proposed procurement of an integrated NHS 111/Out of Hours Service across the five North Central London boroughs. 

1.                Presentation of the Report

Clare Kapoor presented the report to the Board highlighting the following: 

·         The report provides an update on the procurement of one integrated service for both the 111 and Out of Hours services across the whole of North Central London. 

·         Barndoc had provided the Out of Hour’s service in Enfield for many years and were familiar to local residents.

·         The contracts for both Out of Hours and 111 services were coming to an end providing an opportunity to improve all services.

·         40% of 111 calls ended up requiring the Out of Hours services.

·         The benefit of integration would result in fewer hand overs, provide access to a greater range of clinicians and to a direct booking service, avoiding the need for call backs.

·         This will also be an opportunity to improve services for deaf users.

·         An extensive engagement programme has been carried out with both large and small groups and more events were planned.  A patient reference group including four members from Enfield had also been established. 

·         Although there had been a low response to the July engagement exercise, many people had accessed the engagement documents on line and 161 had responded to the on line survey.

·         In July NCL had received a letter from NHS England requesting a pause in the procurement process due to the development of new commissioning standards but this was in line with NCL’s original procurement plans. 

·         Procurement will begin in October 2015 and outcomes will be reviewed by each of the 5 CCGs.  The issues will also be considered by the Joint Health Overview and Scrutiny Committee. 

2.               Questions/Comments

2.1     The contract would last for 5 years.  The NHS was moving to longer term contracts which would enable contractors to commit more resources to improving services. 

2.2     Camden and Islington have carried out focussed engagement with learning and disability services but not Enfield.  Clare would also be attending some parents and deaf user group meetings. 

2.3     It was reported that there was concern about the high numbers of people referred by the 111 service to Out of Hours services and that the 111 service was not staffed by clinicians.  It was felt that people needed reassurance if the contract were to be taken away from the current providers.   There was also concern that smaller local providers would have difficulty bidding for such a large contract and that it would therefore inevitably be let to a big pharma-company.  Local GPs would not be able to compete.   Many local people would prefer locally based services provided by local GPs. 

2.4     There was the potential for larger companies to sub contract the work out at the local level.  A key consideration was the way that the specification would be put together and decisions on the balance between price, quality and social value. 

2.5     Paul Jenkins advised that the service would be clinically led and driven and that patients should receive the similar level of service to that currently provided: that it would still be a local service, just co-ordinated across a wider area. 

2.6     As part of the procurement, finance, quality and governance would be weighted:  one fifth on finance and four fifths quality and governance.

2.7     Since 2005 it had been a struggle to recruit local GPs.  This will remain a challenge, regardless of the model, but will be a consideration in the specification. 

2.8     Two market events had been held and 22-24 providers had attended, including GP consortia.

2.8     Monitoring will take place at the local sub borough level.

2.9     The call centre will be based in London and will be required to be Care Quality Commission registered.  It was felt to be more important to ensure that the out of hours services were locally based. 

2.10    Concern was expressed about the weak consultation and the lack of information about minors and family networks. 

2.11    The directory of services was an important tool to ensure that the local knowledge was available and linked in to the triage system.  A manager would be responsible for making sure that it was kept up to date.  A copy would be made available to Healthwatch. 

2.12    The London Living Wage would be matched. 

2.13    Under 5’s would be referred direct to a clinician.

2.14    The new service would be able to make appointments directly with the out of hours service.

2.15    The new extended primary care access will start in October 2015.  An extra £612,000 has been received to facilitate this.  Initially appointments will be available 6 days a week. 

AGREED to note the proposal to procure an integrated NHS 111/Out of Hours Service across Barnet, Camden, Enfield, Haringey and Islington.