Agenda item

Public Health & NHSE Integrated Sexual Health and HIV Services

Decision:

RESOLVED

KEY DECISION

That the Executive:

a) Delegated authority to the Executive Member for Adults Health and Wellbeing in consultation with the Director of Public Health and the Executive Director of Finance and Performance to extend a Section 75 agreement (or equivalent public sector agreement) for up to two years with partners, NHS England, to jointly commission the Integrated Sexual health and HIV service from April 2023 – March 2025.

b) Agreed to extend the current Northamptonshire Integrated Sexual Health and HIV contract with Northamptonshire NHS Foundation Trust (NHFT)

Reason for Recommendations:

· The recommended course of action is the most cost-effective and likely to match future services with the changing profile of North Northamptonshire’s population

· Accords with legislation or the policy of the Council

· Enables development of the previous decisions of Northamptonshire County Council in September 2018,

· An extension of the NISHH contract with NHFT will provide time to undertake a needs assessment and benchmarking of the service and introduce new KPI’s and targets required to meet the new and emerging needs of the population, identified through this process

Alternative Options Considered – The options available to North and West Northamptonshire are as follows:

a) Extend the current contract with NHFT. This will provide time to undertake a needs assessment and a benchmarking exercise to better understand the emerging needs of the local population. The KPI’s and targets would be updated through a contract variation to ensure the service is fit for purpose and delivering value for money while meeting local need. This will also give time to understand how services have changed and how the learning can be further used to inform future re-commissioning of the new sexual health service in 2025 in line with the wider transformation and strategic aims. Give time for the current Provider to reset and recover from the COVID-19 pandemic.

b) Do not extend the contract, and reprocure the service – the risk is that this would not be completed in time, and risk service disruption. The transformation and strategic ambitions are still being refined and the risk is that the intentions may not be fully embedded in the new service design for 2023.

Minutes:

The Chair invited Cllr Dorothy Maxwell to address the meeting. Cllr Maxwell spoke to query whether specialist nurses were in education settings providing specialist advice on sexual matters and contraception and noted the importance of confidentiality in this regard.

The Chair thanked Cllr Maxwell for her contribution before invitingthe Executive Member for Adults, Health and Wellbeing, Cllr Helen Harrison to introduce a report that sought to update the Executive on the Northamptonshire Integrated Sexual Health Service contract and sought approval to extend for two years in line with the current option to extend clause in the contract.

Responding to Cllr Maxwell’s query, Cllr Harrison stated that the service being discussed did not cover education in schools, although children received education regarding sex and relationships in these settings.

The meeting heard that the Council currently had a contract in place with NHS England for the delivery of mandatory sexual health and HIV services funded through the Public Health ring-fenced grant. The current service was provided by Northamptonshire Healthcare NHS Foundation Trust (NHFT), GPs and pharmacies across the county as an open access service, with the Council also holding the commissioning responsibility for the service on behalf of West Northamptonshire Council.

It was noted that the contract had commenced in April 2019 and was due to expire on 31^st March 2023. However, the contract had a two-year option to extend, ending the current arrangements on 31^st March 2025. Extending the contract for a further two years would incur a total cost of £18.512m, with the Council’s contribution being £4.655m as per the agreed contribution agreement.

Cllr Harrison reported that work had commenced to review areas requiring further development and improvement and to refresh the current performance monitoring schedule, with service improvement plans introduced to closely monitor for improvement in activity. Evaluation frameworks would also be introduced to measure the impact of the service, benchmarked against regional and statistical neighbours.

It was noted that HIV treatment services were currently delivered by NHFT, in full alignment with the Integrated Sexual Health Services commissioned by the Council. Any disruption of this existing alignment was expected to increase costs, impact on recruitment and retention of high-quality clinical staff and reduce accessibility for service users. Agreement to extend the current contract would allow the Council and the Northamptonshire Integrated Care system to review the profile of need for the service, as well as to creatively look at delivery options to develop a service that best suited the population requiring it.

Both Cllrs Pentland and Brackenbury spoke in favour of the recommendations noting the importance of supporting those requiring access to the service and the opportunity to review the existing offer in the additional time afforded by agreeing an extension to the contract.