1. NHS Medway CCG community contracts Carole Eastwood / Penny Hever Programme Managers (Commissioners ) Richard Barrett Category Manager (Procurement)

2. Welcome and Introductions

3. Agenda Friday 17 July pm 12.30 Introduction 12.45 Tissue viability, wound therapy, lymphoedema and podiatry commissioning and procurement intentions 1.15 Coffee 1.30 Table top discussions 2.30 Questions, answers and feedback 2.45 Way forward 3.00 Close

4. Services being tendered Wound Care and Tissue Viability

5. Who is the service for? For residents of Medway who have an open wound, or are at risk of skin breakdown because of trauma or disease processes.

6. Priorities and approach Aim: to deliver services based on holistic needs with episodes of treatments being focused on wound healing and prevention of skin breakdown in the primary care setting and reducing preventable admissions to secondary care. Achieved by: establishing evidence based care plans education of patients, carers and health professionals collaborative working with primary care to develop integrated systems, improving communications and patient outcomes.

7. Priorities and approach Dressing Optimisation Scheme – to be recommended and managed within a defined budget (including identified savings) across all community health, primary care and nursing homes without compromising patient care, and undertaking of an annual prescribing review in collaboration with Medicines Management Collaborative working - with primary care to develop integrated systems and improving communication and patient outcome. Providers working together to reduce the need for secondary care admissions. Develop integrated processes and procedures that discourage duplication and encourage a seamless journey for the patient.

8. Priorities and approach Specialist technical treatments available for wound therapy Routine post op care Specialist advice, joint assessment, vascular clinics, debridement, minor skin procedures Independent prescribing to be available – reducing need for GP appointments and delaying treatment. Support patient with self-care and independence Wound care for children

9. Priorities and approach Variety of locations preferably in Healthy Living Centres to provide patient choice and ease of access Extended hours Service available 52 weeks of year Tissue Viability specialist nurses visiting patients in their home, residential homes, nursing homes, prison young offenders unit and community hospitals.

10. Activity and budget Apr 14 to Mar 15 Referrals: 7,939 Contacts: 20,580 Current Value: £806,000

11. Services being tendered Lymphoedema

12. Who is the service for? Any patient with chronic oedema for a duration of 3 months or more which has not resolved with diuretics or elevation and no major medical causes of swelling have been identified. This also includes: – Midline oedema (head, neck, trunk, genitalia) – Long term complications due to radiotherapy or surgery – Non-responders to standard cellulitis management – Hosiery fitting problems.

13. Priorities and approach Aim: to provide a comprehensive, community based service for all patients with lymphoedema, regardless of course, with access to appropriate treatment nearer to their home, avoiding hospital treatment and improving patients quality of life. Achieved by: establishing evidence based care plans education of patients, carers and health professionals advising and supporting patients with chronic oedema in order to prepare patients for long term independence.

14. Priorities and approach Priority to be given to palliative care referrals. Specialist equipment including bariatric equipment available in service. Stock of bandages and compression garments. Hosiery not available on FP10 to be ordered and prescribed directly from the service budget.

15. Priorities and approach Variety of locations preferably in Healthy Living Centres to provide patient choice and ease of access Extended hours Service available 52 weeks of year Lymphoedema specialist nurses visiting patients in their home, residential homes, nursing homes, prison young offenders unit and community hospitals.

16. Activity and budget Apr 14 to Mar 15 New: 150 Follow up: 650 Current contract value £220,000

17. Services being tendered Podiatry

18. Who is the service for? Patients over the age of 18 Exception of verruca and nail surgery for children Service to be offered in community hospitals, residential homes, clinic settings, patient homes and Healthy Living Centres.

19. Priorities and approach Aim: to deliver services based on integrated holistic multi disciplinary service which makes a positive contribution to improving the medical conditions affecting the foot and lower limb of the local population. Achieved by: establishing evidence based care plans education of patients, carers and health professionals collaborative working with primary and secondary care to develop integrated systems, improving communications and patient outcomes.

20. Priorities and approach Specialist services to include biomechanics, nail surgery, rheumatology, footwear clinic and orthotics. Sterilisation service included Domiciliary service Supplementary prescriber In hospital patient care (acute hospital, rehab units) Foot health education, information and public health information

21. Priorities and approach Variety of locations preferably in Healthy Living Centres to provide patient choice and ease of access Extended hours Service available 52 weeks of year

22. Activity and budget Apr 14 to Mar 15 Referrals: 5,229 Contacts: 19,679 Current Value: £917,000

23. Procurement Process The Restricted Procedure is likely to be used A European Advert OJEU Followed by a PQQ (Shortlist) Followed by ITT (Award)

24. Proposed contractual approach Lot 4 – Tissue viability and wound care Lot 5 – Lymphoedema Lot 6 – Podiatry Possibly lead provider subcontracting activity Proposed Contract Duration: TBC

25. Timetable July 2015 – Supplier Engagement Via Portal July 2015 - OJEU July/Aug 2015 – PQQ Aug/Sept 2015 - ITT January 2016 – Award Jan/March 2016 - Mobilisation 1 st April 2016 – Go Live

26. Procurement Portal Kent Business Portal www.kentbusinessportal.org.ukwww.kentbusinessportal.org.uk Register and select relevant categories Notification when tender published Every stage, all documentation on the portal Free

27. Table top discussion What do you think will be the opportunities in delivering this service in Medway? What do you think are the challenges in providing the service in Medway? Innovation in delivering the service.