Public procurement notice: Modification Of A Contract/Concession During Its Term
Published: 2021-04-30
Buyer: NHS Fareham and Gosport CCG
Country: UK
Contract type: Services
Procedure: Negotiated without a prior call for competition
CPV classification: 85100000: Health services

Technical requirements: The original procurement was for annual costs of GBP 19 085 000 (GBP 133 595 000 over the maximum 7-year contract term) with potential additional costs to be agreed of GBP 2 994 000 (GBP 20 958 000 over 7 years), a total of GBP 22 079 000. As we approach contract mobilisation, we have greater certainty of the additional costs above but the costs of 111 First on an ongoing basis are still being reviewed. Nevertheless, we are clear that the maximum annual value of the contract, allowing for reasonable levels of activity growth and inflation, will not exceed GBP 24 485 000, an increase of GBP 2 406 000 (10.90%%) compared to the original procurement. All of this additional cost relates to delivery of the additional national 111 First requirements.
The contract holder South Central Ambulance Services NHS Foundation Trust will be issuing similar notices for the 2 subcontracts which form part of the main contract. These sub-contract arrangements are as referenced in EU notice reference 2020/S 214-525835 (issued by SCAS) and 2020/S 036-086328 (The Contracting Authority Contract Award Notice).
As a result of NHS England mandating the implementation of ‘111 First’ nationally (partly as a response to the pandemic), commissioners have had to procure additional services within the forthcoming IUC contract over and above what was included in the original procurement, both in terms of additional call volumes and an additional level of clinical validation. NHS organisations, including commissioners plus acute, ambulance and primary care providers, are working together to deliver this enhancement to the NHS 111 service in a coordinated way within the four local integrated care partnership (ICP) areas – Portsmouth and south east Hampshire, North and mid Hampshire, Southampton and south west Hampshire and the Isle of Wight. The initiative is part of a national requirement, with an ambition that all systems will have implemented a minimum specification of the clinical model by December 2020, as set out at the NHS England and NHS Improvement Board Meeting in Common held on 28 July 2020. https://www.england.nhs.uk/publication/nhs-england-and-nhs-improvement-board-meetings-in-common-agenda-and-papers-28-july-2020/. This was, subsequently endorsed by a directive within the Third Phase of the NHS Response to Covid-19 letter from Simon Stevens (NHS England, 31 July 2020).By developing the current NHS 111 service to offer patients a different approach to the way they seek out and receive urgent healthcare, we are able to:
• promote NHS 111 (both online and via existing telephony) as the first point of contact for people experiencing a non-life-threatening health issue;
• encourage a move away from (but not exclusion of) going to a physical location as the first choice to access healthcare when it is needed urgently;
• prevent nosocomial infection by minimising the opportunity for patients to congregate together in ED waiting rooms;
• ensure patients get a clear direction of what they need to do and where they need to go in order to resolve their issue;
In short, there are fundamental benefits to the requirement to keep people who need urgent care, and those who treat them, safe – preventing the spread of infection which could be brought about by having too many people grouped together at any one time. Key functions and enhancements from this service include:
• clinical triage of all ED and lower category ambulance dispositions. The anticipated main benefits from the enhanced contract will be:
As this was an increase in the scope of the existing contract, and was an integral part of it, there was no option but to use the same provider as this additional work could not be provided separately from the main contract. Business continuity for this essential service is covered robustly by the policies and procedures already designed and managed by our existing providers, so a separate procurement and award for a small integrated part of the overall contract would not be feasible. This modification does not change the overall nature of the contract. As we approach contract mobilisation, we have greater certainty of the additional costs above but the costs of 111 First on an ongoing basis are still being reviewed. Nevertheless, we are clear that the maximum annual value of the contract, allowing for reasonable levels of activity growth and inflation, will not exceed GBP 24 485 000, an increase of GBP 2 406 000 (10.90%%) compared to the original procurement. All of this additional cost relates to delivery of the additional national 111 First requirements.
As a result of NHS England mandating the implementation of ‘111 First’ nationally (partly as a response to the pandemic), commissioners have had to procure additional services within the forthcoming IUC contract over and above what was included in the original procurement, both in terms of additional call volumes and an additional level of clinical validation. NHS organisations, including commissioners plus acute, ambulance and primary care providers, are working together to deliver this enhancement to the NHS 111 service in a coordinated way within the four local integrated care partnership (ICP) areas – Portsmouth and south east Hampshire, North and mid Hampshire, Southampton and south west Hampshire and the Isle of Wight. The initiative is part of a national requirement, with an ambition that all systems will have implemented a minimum specification of the clinical model by December 2020, as set out at the NHS England and NHS Improvement Board Meeting in Common held on 28 July 2020. https://www.england.nhs.uk/publication/nhs-england-and-nhs-improvement-board-meetings-in-common-agenda-and-papers-28-july-2020/. This was, subsequently endorsed by a directive within the Third Phase of the NHS Response to Covid-19 letter from Simon Stevens (NHS England, 31 July 2020).By developing the current NHS 111 service to offer patients a different approach to the way they seek out and receive urgent healthcare, we are able to:
• promote NHS 111 (both online and via existing telephony) as the first point of contact for people experiencing a non-life-threatening health issue;
• encourage a move away from (but not exclusion of) going to a physical location as the first choice to access healthcare when it is needed urgently;
• prevent nosocomial infection by minimising the opportunity for patients to congregate together in ED waiting rooms;
• ensure patients get a clear direction of what they need to do and where they need to go in order to resolve their issue;


Winner: South Central Ambulance Service NHS Foundation Trust