'Unaffordable' urgent care procurement halted

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Services covered will be re-examined
Procurement was meant to lead to better integration
NHS111 and clinical advice services will now be procured across Kent, Medway and Sussex

Procurement of urgent treatment centres and GP out-of-hours services across two clinical commissioning groups has been discontinued – because the money on offer was not enough to attract providers.

Swale and Medway CCGs are now drawing up a new specification for the services which are meant to offer more integrated care.

The CCGs had originally planned for UTCs at Sittingbourne Memorial Hospital, Sheppey Community Hospital, and Medway Foundation Trust. The two Sheppey UTCs – which would replace minor injury units and GP-led walk in services – would be supported by a mobile service, with GP OOH bases at both hospitals in Swale.

The UTC service at Medway would also see some patients “streamed” from the emergency department and have a GP OOH base co-located at the site in Gillingham.

A report to Kent County Council’s health overview and scrutiny committee says “the CCG [Swale] had approached the market and found that the range of services requested was unaffordable….the range of services, and the siting of these services will need to be explored”.

A new contract was originally expected to be in place from April but the abandonment of the procurement process in late 2018 has meant the existing providers have been approached to continue with the contracts. The CCGs are planning to go out to tender in 2019-20 but would not give an indicative value for the contract because it is seen as “commercially sensitive”.

The abandonment of the procurement illustrates the difficulty of CCGs procuring urgent care services in a rapidly changing situation. The Kent CC report points out that a review of what is needed will allow the impact of extended hours GP access to be considered, together with how the UTC at Medway affects patient flows. However, if major changes were made to the service specification then public consultation might be needed.

The Medway and Swale tender had only gone ahead after a wider procurement of NHS111 and clinical advice services covering the whole of Kent and Medway was halted in April last year. The “face- to-face” services for Swale and Medway had been included as a separate lot in this.

When this was halted, it was decided to tender separately for the Swale and Medway services. Currently patients in Swale can access GP OOH services with bases at both the Sheppey and Sittingbourne sites, nurse-led minor injury units at both sites, a GP-led walk in centre at Sheppey and a mobile unit in Sittingbourne, or can travel to the UTC at Medway Maritime Hospital. One of the aims of the procurement was to provide a more integrated service with a single provider.

Meanwhile, the 15 Sussex, Kent and Medway CCGs are now planning to jointly procure a NHS 111 and clinical advice service after previous procurements were halted last year. All CCGs have agreed to form a joint committee to take this forward.