Primary Care Provided Phlebotomy Services

Descriptions

As per published PIN with call for competition 2022/S 000-001180., The Contracting Authority will enter into a contract with all 12 of the Isle of Wight GP Practices for the reasons detailed below., The contract is for a period of 3 years commencing 1st March 2022 with the option to extend for a further 2 x 1 year periods. , Value below includes optional extension period i.e 5 year maximum cost at higher tariff rate., When the Covid - 19 pandemic hit in 2020, the IW Trust notified the IW CCG that they were unable to deliver the GP requested blood tests in a safe environment. This is due to the delivery model being based at the IOW Hospital, with walk-in sit and wait only, which posed a risk to people as there could be 50+ at any one time in the same room., In response, Providers on the Isle of Wight were contacted to see whether they could deliver this activity, including:, • IW Trust (Acute and Community Division), • All GP Practices, • Primary Care Providers, including One Wight Health GP Federation, The only Providers that could deliver the service were the GP Practices, and it was mutually agreed by the CCG, IW Trust and Primary Care Providers that the GP Practices would increase their capacity to accommodate the GP requested blood tests previously completed, by the IW NHS Trust, within a defined scope., This needed to be put in place urgently, so the Isle of Wight CCG agreed to put in place an emergency primary care LCS contract variation between July 2020 and February 2022, to cover the increased activity to Primary Care., The service was critical for the CCG and IW population, so the full procurement process was not possible at this stage due to the need for service continuity and the capacity of the CCG and Providers to complete a procurement during a pandemic., The IW phlebotomy service is now at a critical stage, as the current contract variation with GP Practices ending 28th February 2022., This contract award is due to the following reasons:, • Ensuring service continuity for patients: The NHS is in a period of unprecedented pressure, and change due to the Covid pandemic. It will take a considerable amount of time to get through the pandemic and recovery, during which diagnostics needs to remain stable for continuity of care., • NHS Strategic changes to embed:, o There is a significant amount of change happening across the ICS and particularly within Primary Care. The NHS England and NHS Improvement 5 year Primary Care Network (PCN) priorities are:,  Improving prevention and tackling health inequalities in the delivery of primary care,  Supporting better patient outcomes in the community through proactive primary care,  Supporting improved patient access to primary care services,  Delivering better outcomes for patients on medication,  Helping create a more sustainable NHS, o As phlebotomy is key to all of these priorities as a diagnostic and management tool, it is vital that the service model meets the need of patients and helps providers achieve the priorities outlined above., • Activity baseline needs to stabilise: The activity baseline varies considerably at the moment due to:, o A large back-log of GP requested blood tests due to the recent blood tube shortages and pandemic. NHS England wrote a letter directing "All primary care and community testing must be halted until 17 September 2021, except for clinically urgent testing", which meant a 50% reduction of Primary Care blood tests and 25% reduction of hospital blood tests. The GP Practices are now permitted to gradually increase blood tests over the next couple of months. This has a widespread impact on care, such as the annual reviews, diagnosis, local, commissioned services etc. Therefore, agreement across Hampshire, Southampton, Isle of Wight CCG is to have payment protection in place for local commissioned services, which includes Phlebotomy., o The changes outlined above in terms of PCN DES diagnostic and management impact, o The activity baseline set at 2018/19 prior to the Covid-19 pandemic. Actual activity seen is lower due to many reasons, such as the Covid-19 pandemic pausing QOF, advances in medications such as the move from Warfarin top DOACs reducing monitoring etc. therefore, a true baseline needs to be establish over the next 2-3 years to inform future budget setting.