Public procurement notice: Voluntary Ex Ante Transparency Notice
Published: 2018-05-12
Buyer: NHS Wirral CCG
Country: UK
Contract type: Services
Procedure: Negotiated without a prior call for competition
CPV classification: 85100000: Health services | 85121283 | 85140000: Miscellaneous health services | 85142100 | 85323000
Estimated value: 125000000 GBP
Award criteria: The most economic tender

Technical requirements: The proposed contract award is to appoint a prime provider of a new integrated musculoskeletal triage service, which encompasses Physiotherapy, Orthopaedic Surgery, Orthopaedic Outpatients, Rheumatology, Pain Management, Podiatry and a direct access musculoskeletal triage service and clinical assessment service to route patients to the most appropriate care pathway. The service is to be provided to Wirral residents registered with a Wirral GP, in accessible locations within the peninsula boundary. It is anticipated the contract value will be circa 25 000 000 GBP per annum.
The proposed contract award is to appoint a prime provider of a new integrated musculoskeletal triage service, which encompasses Physiotherapy, Orthopaedic Surgery, Orthopaedic Outpatients, Rheumatology, Pain Management, Podiatry and a direct access musculoskeletal triage service and clinical assessment service to route patients to the most appropriate care pathway. The service is to be provided to Wirral residents registered with a Wirral GP, in accessible locations within the peninsula boundary.
Constitutional referral to treatment (RTT) waiting times are currently being failed in Wirral due to the lack of integrated service provision. Service reform and integration is required at pace so as not to further disadvantage the health needs of Wirral residents. It is believed that no other economic operator can deliver the scope of the integrated services required. The limitations include: no other economic operator has the facilities or resources available in Wirral to deliver these health services at the capacity required to fulfil the specification without sub-contracting more than 30 % of the services. No other economic operator has the facilities to deliver the vast majority of all elective orthopaedic procedures which makes up a large part of this contract opportunity, as is integral to releasing efficiencies within the system. This would require an operator to commission, fund and build a suite of operating theatres, and also develop additional sites for primary care and other linked secondary care services, and be in a position to launch services prior to the Winter 2018 pressures to the health system. NHS Wirral CCG appreciates there are economic operators whom offer primary care MSK triage services, however we are not aware of any that offer a fully integrated service which encompasses elective orthopaedics, which is essential to the delivery of the proposed contracting model.
It is anticipated that an element of community physiotherapy, podiatry and additional capacity of elective orthopaedics will be sub-contracted to ensure referral to treatment targets are met and patient choice is available. The provider (an awarding authority in their own right) will competitively tender their sub-contractors in compliance with the Public Contract Regulations 2015.
Musculoskeletal (MSK) related services are currently fragmented across Wirral, with multiple providers of both community based primary care services and secondary care and elective services. Constitutional referral to treatment targets are not being met and surgical conversion rates are low, which suggests inappropriate referrals are being made to current services. Introduction of a Physiotherapy led Musculoskeletal Triage and Clinical Assessment service have been proven effective in other areas of England to resolve the issues prevalent in Wirral. To improve on this model further we seek to integrate onward MSK related services within a single capitated budget to incentivise the prime provider to deliver care in the most appropriate manner and in the most cost effective manner. A single capitated budget for all mentioned services will allow the provider to utilise efficiencies gained from a reduction in inappropriate secondary care referrals to re-invest into prevention and self-care. This VEAT notice serves both as a transparency notice and a standstill period on our intention to award this contract. Wirral CCG issued an OJEU PIN notice with call for competition (OJEU REF: 2017/S 044-080468) in February 2017, followed by an Invitation To Tender in June resulting in only one qualifying provider (Wirral University Teaching Hospital NHS Foundation Trust) expressing their interest to provide these services as a prime provider with a capitated budget. Therefore, following the 10 day standstill period, if the CCG receives no substantiated objections, the CCG aims to conclude the proposed contract with Wirral University Teaching Hospital on or after 12:00 noon 21.5.2018. Key contact to detail any objection to this VEAT notice – Siju George via email sijugeorge@nhs.net.


Winner: Wirral University Teaching Hospital NHS Foundaton Trust
Award value: 125000000