HSJ’s round-up of the day’s must read stories

Largest ever NHS tender

Manchester health leaders have kicked off the search for providers of “out of hospital” health and care services across the city under a contract worth nearly £6bn – the largest ever NHS services tender.

A tender document, published by NHS Shared Business Services, sets out for the first time the contract value and other details of the ambitious plan to set up a “local care organisation” to provide all non-acute services – including social care – across the city.

The LCO will hold a single 10 year contract to provide services for a population of around 600,000 across the city – but not the entire Greater Manchester devolution region. The contract will be let by Manchester Health and Care Commissioning, a partnership between the city council and a newly formed single clinical commissioning group.

The deal is far larger than other significant tenders by local NHS commissioners which include a similar project, the proposed a £2bn MCP contract in Dudley, which is also in the early stages.

Under the original devolution timeline, the new contract was due to begin operating this month.

The city’s new acute provider, which is being created through the merger of Central Manchester University Hospitals Foundation Trust and University Hospital of South Manchester FT, is expected to bid for the deal. The merger is currently going through competition clearance.

Brexit crystal ball

After Brexit the NHS could be hit by a shortage of more than 40,000 nurses by 2026, according to modelling by the Department of Health leaked to HSJ.

Such a fall in the number of nurses and midwives would leave the NHS “unsafe”, the head of the RCN warned, and has prompted serious concern among ministers and officials at Richmond House as the UK heads into Brexit negotiations with the EU.

The modelling, carried out by DH civil servants, forecasts a worst case scenario for the UK where all EU and non-EU inflows of nurses and midwives stop after changes to immigration rules. The modelling shows a decline in nurses from 2019, when the UK is expected to exit the EU and could introduce immigration restrictions (see our graph). If all EU and non-EU inflows stopped, this would create a shortage of nurses in the health and care sector of between 26,000 and 42,000 by 2025-26, compared to the forecast base case supply.

While this is considered unlikely to happen, any impact on workforce supply from Brexit and increased demand on services could place considerable pressure on the NHS and be a risk to patient safety. Research has frequently shown patient safety is linked to the number of nurses caring for patients.

The information, seen by HSJ, said: “The analysis indicates that there is a severe risk of undersupply if immigration rules change and international inflows stop.”