Sexual Health Services: Insight from the procurement of services in Leeds Vicky Womack & Sharon Foster -Public Health

The challenge….. Commissioning across the system & Do we have to go out to reprocure?

Leeds Core City: 750,000 population □ large student population □ large msm scene □ large migrated population HIV late diagnosis: 47.3% Prevalence 2.39 / 1,000 Over 1,000 people living with HIV

Procurement process - Decisions LA’s will be making □ What’s in scope to be procured?  One provider for all service provision - clinical and prevention services  One provider and sub contracting  Separate providers / you may see procurements using ‘lots’  Joint commissioning? □ Is it a full service redesign or a like for like procurement? □ How are existing contracts performing? □ Who is in the market to provide the services – competition is needed - it helps tell commissioners what good looks like

What are commissioners looking for? □ The system working together to bid for services □ The system working together to manage service users through the pathway □ Bidders - being ‘innovative’ □ Strong service user involvement and insight informing your tender submission

Cont…. □ Do you have links with primary care □ Value for money - can you work with partners (share premises/ back office functions = more £ into delivery) □ Tell us how you will contribute to delivering PH outcomes – be explicit! □ Work with clinical providers - we like the 3 rd sector – highlight your USP

Tips for bidders □ Common sense but read method statement questions carefully and make sure you answer the question (make it relevant for the local area) □ It’s like in any interview situation – don’t presume we know information, we can only score of what is in your bid □ Bring the pathway / SU experience alive in your bid □ Do talk about the links and role you have with partners / national agencies □ Is your service political (engage the right Cllr in HIV testing week, invite them to key events –good news stories are good for everyone) □ Good relationships do count through the process

The commissioners challenge - how do we get providers to work together? □ Local partnerships – HIV / SH networks □ Through providers having the initiative and skills to develop their own partnerships □ Through procurement and service re-design – the process (often) encourages collaboration □ Through KPIs and contracting –  Indicators to support system commissioning

ISHS - Clinical Service Specification KPIs  HIV testing uptake at first appointment in msm & BAC  Increase number of msm undertaking a sexual health screen  % of MARPS receiving a intervention to reduce risky behavior  Number of people diagnosed with a CD4 count below 350  Number of referrals into the 3 rd sector  Multi-professional contact kept to a minimum  All newly diagnosed HIV+ to be given information and support to access 3 rd sector support

HIV Prevention Service Specifications - KPIs □ Number of referrals from the Integrated Sexual Health Service of newly diagnosed positive □ Number of BAC/ MSM accessing HIV / STI testing in the ISHS □ Number of people diagnosed with a CD4 count below 350 □ Increase in the referrals from the Integrated Sexual Health Service to work with vulnerable MSM

Leeds HIV Services in 2015 □ Integrated SH service – Improved access and choice □ Two HIV prevention contracts (8 years) – MSM & BAC Both providing core prevention & outreach, using social media to engage / community leaders & providing community testing clinics □ CCG funded HIV testing in MAUs in acute trust (15-65 year olds) □ CCG funded 3 x abortion contracts providing HIV testing □ Collaborative working between Public Health & CCGs looking at how we offer BBV screening in Primary Care at new patient registration (38 /113 GP surgeries in high prevalence areas) □ Partnership approach to deliver HIV testing week