Integrated Urgent Care – Call Handling, Clinical Assessment Service and GP out of Hours

NWL CCGs (as described in Section VI.3 below and hereinafter referred to as the “CCGs”) have awarded three contracts for the provision of an integrated urgent care service in North West London (“NWL”). The arrangement will provide the following: the call handling service of 111; the clinical assessment service for 111; and GP out of hours services. The 111 service is a critical part of the NWL urgent care infrastructure and key to enabling a person to be treated in the right place at the right time.

111 Call handling service

London.

Lot 1 concerns the provision of 24/7, 365 day 111 call handling services. 111 is a nationally mandated service and is a key element of the NWL urgent care infrastructure. Pathways trained service, health and clinical advisors help ensure patients are guided to the appropriate service to meet their needs. Lot 1 has been awarded to the London Ambulance Service NHS Trust (“LAS”) with London Central and West Unscheduled Care Collaborative (“LCW”) and Practice Plus Group Urgent Care Limited (“PPG”) as mandated sub-contractors. This collaboration of providers enables NWL to test the opportunities for integration between the 999 and 111 service whilst maximising opportunities to connect pathways of care due to the understanding of care delivery across the Integrated Care System during the term of the agreement. The service to be delivered for callers across NWL, is through organisations accredited to use NHS Pathways, with a clear and detailed understanding of patient need and urgent care pathways in NWL and a good track record of delivery of 111 services.

Following detailed consideration the CCGs believe that there are opportunities to integrate and streamline call handling between the 999 service and the 111 service. Due to the integration opportunities with the 999 services LAS is the only provider capable of delivering Lot 1.

To ensure resilience and integration, LAS will hold contracts with LCW and PPG as Material Sub- Contractors delivering part of the 111 call-handling supported by an Alliance Agreement.

The form of contract is the NHS Standard Contract.

Clinical Assessment Services and GP Out of Hours services

London.

Lot 2 consists of two contracts each for a 111 clinical assessment service and GP out of hours services. One contract has been awarded to LCW and the other to PPG. The collaboration between Lot 1 and Lot 2 providers is supported by an Alliance Agreement. Lot 2 concerns the provision of a 111 clinical assessment service operating 24/7, 365 days a year together with the provision of GP Out of Hours services as part of an integrated urgent care model of care to be delivered across NWL. The 111 clinical assessment service will work alongside the Lot 1 111 call handling service ensuring that where indicated, patients have access to a clinician who will review their urgent care needs and determine how best these are met. The Lot 2 providers will need to work with the Lot 1 provider, LAS, for elements of the clinical assessment service. The providers will also need to deliver GP out of hours services for NWL practices that do not provide this service directly.

The CCGs rely on Regulation 32(2)(b)(ii) to enter into the Lot 1 and Lot 2 contracts.

LAS is the provider of the 999 service in NWL. Following detailed consideration the CCGs believe that there are opportunities to integrate and streamline call handling between the 999 service and the 111 service. This will ensure greater resilience in times of surge and unexpected demand. In turn, providing access to the right care for our patients and the right advice for staff such as LAS crews, will reduce calls on other parts of our urgent care system such as conveyance to emergency departments, leading to a more robust and less pressured system overall. Due to the integration opportunities with the 999 services LAS is the only provider capable of delivering Lot 1 and therefore competition is absent for technical reasons. Under Lot 1 contract, LAS will be engaging LCW and PPG as sub-contractors.

Lot 2 concerns the provision of a 111 clinical assessment service operating 24/7, 365 days a year together with the provision of GP Out of Hours services as part of an integrated urgent care model of care to be delivered across NWL. The clinical assessment service will work alongside the Lot 1 111 call handling service ensuring that where indicated, patients have access to a clinician who will review their urgent care needs and determine how best these are met. To ensure resilience and integration, the providers of the clinical assessment service and GP Out of Hours service will need to work with the provider of the 111 Service. Due to the need for close integration with Lot 1 provider, the Lot 2 contracts can only be delivered by Lot 1 mandated sub-contractors.

An Alliance Agreement between the CCGs, LAS, LCW and PPG has been entered into in order to set out the objectives for a coordinated delivery of the entire Integrated Urgent Care service.

As part of its assessment of the application of Regulation 32, the CCGs published a Prior Information Notice (PIN) on 26 October 2020. Providers who believed they had the capability and capacity to deliver the services were invited through the PIN to contact the CCGs to explore the Integrated Urgent Care service. The results of this engagement further confirmed that for both Lot 1 and Lot 2, only the providers identified in this notice have the technical capability to deliver the contracts to which this notice concerns.

111 Call Handling Services

To ensure resilience and integration, LAS will hold contracts with LCW and PPG being Sub-Contractors delivering part of the 111 call-handling supported by an Alliance Agreement.

Clinical Assessment Services and GP Out of Hours Services

Clinical Assessment Services and GP Out of Hours Services

The CCGs are:

(1) NHS Brent Clinical Commissioning Group;

(2) NHS Central London Clinical Commissioning Group;

(3) NHS Ealing Clinical Commissioning Group;

(4) NHS Hammersmith and Fulham Clinical Commissioning Group;

(5) NHS Harrow Clinical Commissioning Group;

(6) NHS Hillingdon Clinical Commissioning Group;

(7) NHS Hounslow Clinical Commissioning Group; and

(8) NHS West London Clinical Commissioning Group.

The value of the Lot 1 contract is GBP 27 577 766.00. The indicative value of Lot 2 is GBP 31 040 864. Payments will be made to the suppliers in accordance with the activity performed under each contract. The value given is based on projected activity.