Agenda item

Commissioning Intentions for the GUM Service

Minutes:

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 1st 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 provision of sexual health services.  The plan for the region was to upscale online self-sampling (testing) service for Sexually Transmitted Infections which continued to rise, and divert testing for those patients showing no symptoms of infections to community access points.  This new model was being piloted by King’s College Hospital NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust, with the final model expected to be in place by April 2017.  It was proposed that Lambeth would negotiate an arrangement to secure new GUM provisions from these providers from April 2017 with the direct involvement of all four boroughs, and that a Memorandum of Understanding to support the collaborative management of these contracts be established between Lambeth and Bromley.

 

Samples of the testing kits provided through the online self-sampling service were shown to Members who were advised that the kits were posted in plain packaging and that online videos were available to support users with the testing process.  In response to a question from a Member, the Assistant Director: Public Health confirmed that the potential to establish a ‘click and collect’ style service for the kits from community pharmacies was being considered and that this would provide opportunities for direct advice to be given on preventative measures.

 

RESOLVED that the Council’s Executive be recommended to:

 

1)  Note the benefits of the London-wide Collaborative arrangement and approve the continuation of this arrangement to provide open access Genito-urinary Medicine (GUM) service in London for Bromley residents, estimated to cost £1,609k per year;

2)  Approve the phased approach to implementing the London Sexual Health Integrated Tariffs starting from 2017/18; and,

3)  Approve the South East London arrangement to secure the provisions of new GUM services from Kings College Hospital NHS Foundation Trust and Guy’s and St. Thomas’ NHS Foundation Trust for Bromley residents from 1st April 2017 and to authorise the Sexual Health Commissioner to enter into a Memorandum of Understanding with the London Borough of Lambeth to enable the London Borough of Bromley to access the arrangement.

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