Issue - meetings

Report CS17051

Members received a report setting out intentions for the provision of Genito-urinary Medicine (GUM) Services for 2017/18. The Council had a duty to provide open access health services, and this was secured using a collaborative commissioning approach with other London boroughs in contract negotiations with GUM providers to achieve lower unit prices for first and follow up attendances. This was supported by a Collaboration Agreement, with LB Lambeth acting as lead borough for South East London.  The proposals had been supported by the Care Services PDS Committee at their meeting on 13^th October 2016.

(During consideration of this report Councillor Peter Fortune declared an interest as his mother worked at Guys Hospital.)

RESOLVED that

(1) The benefits of the London wide Collaborative arrangement be noted and the continuation of this arrangement to provide open access GUM service in London for Bromley residents, at an estimated cost of £1,609k per year, be approved.

(2) The phased approach to implement the London Sexual Health Integrated Tariffs be approved, starting from 2017/18.

(3) The South East London (SEL) arrangement to secure the provision of new GUM services from Kings College Hospital NHS Foundation Trust (KCH) and Guys and St. Thomas NHS Foundation Trust (GSST) for Bromley residents from April 2017 be approved and thesexual health commissioner be authorised to enter into a Memorandum of Understanding (MoU) with the London Borough of Lambeth to enable the London Borough of Bromley to access the arrangement. 

Report CS17051

The Care Services Portfolio Holder introduced a report setting out the Public Health intentions for the provision of Genito-urinary Medicine (GUM) Service for 2017/18.

The Local Authority had a statutory duty to provide open access sexual health services, by which services should be available to anyone requiring treatment without referral.  The Sexual Health Commissioner had pursued a collaborative commissioning approach for GUM services with other London Boroughs to achieve lower unit prices and marginal rates.  This arrangement was supported by the Collaboration Agreement between various local authorities across London to provide GUM services, which set out the roles and responsibilities of each borough, including financial organisations.  Under the Collaboration Agreement, Lead Boroughs were nominated to enter into annual contracts with providers to deliver services to all participating authorities within the region.  Bromley’s actual spend in 2015/16 on GUM at tariffs negotiated by the London Collaborative had been £1,524k in London with a total spend of £1,578k including services outside of London.  This reflected a saving of over £60k compared to the previous year, despite an overall 4.5% growth in activities.

The continued growth of activities had led to further collaboration amongst London commissioners to contain escalating costs.  The London Sexual Health Transformation Programme was set up to reduce costs for sexual health care across London, specifically GUM services through innovation, service redesign, demand management and pricing strategy.  This included work on a new set of prices for London known as the London Integrated Sexual Health Tariffs that reflected the interventions provided by GUM and the Contraceptive Services more accurately than attendance-based tariffs and was expected to achieve significant cost savings across London.  There was broad agreement across London that Integrated Sexual Health Tariffs would be the payment mechanism for sexual health services from 1^st April 2017.  Locally, arrangements were in place to shadow Integrated Sexual Health Tariffs during 2016/17 to understand the direct impact of implementation and extent of savings that could realistically be achieved.  Further discussions with commissioners were required to determine how implementation could effectively take place due to different contractual arrangements both within the region and across London, and it was therefore proposed to implement Integrated Sexual Health Tariffs on a phased approach starting from 2017/18.

Given the need for continued collaboration across London and the level of change required, it had also been agreed by the London Sexual Health Transformation Programme that transformation would be more effective and responsive implemented at sub-regional level.  Bromley was part of the South East London region and shared the same GUM providers as the London Boroughs of Lewisham, Southwark and Lambeth, of which Lambeth was the Lead Authority and had negotiated tariffs and entered into contracts with King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust under the London collaborative arrangement.  Significant innovation had already taken place in the South East London region over recent years, with a major drive of clinical and cost effective interventions that promoted self-management, including online  ...  view the full minutes text for item 34