Report ACH22-037

This Committee considered a report which sought Executive approval to commence the procurement of the substance misuse contracts. The Assistant Director – Public Health advised that Members of the Adult Care and Health PDS Committee were asked to note and endorse the recommendations to the Council’s Executive.

The London Borough of Bromley had a statutory duty to improve the health of the population and to provide local public health services including arrangements to secure the provision of substance misuse services for adults and young people. Substance misuse services were currently provided by CGL (Change, Grow, Live) who delivered the adult substance misuse service, BDAS (Bromley Drug and Alcohol Service) and the young people’s substance misuse service, Bromley Changes at an estimated whole value of £7,490k. Both contracts are due to expire on 30^th November 2023. In recent years the Service had received additional grants from the Office for Health Improvement and Disparities (OHID) to increase the capacity and scope of the Contracts. Further grants were likely to be made available for 2023/24 and 2024/25.

It was proposed that:

a)  the current contracts be varied to reflect increased demand for the period from 1^st December 2022 to 30^th November 2023 at an estimated value of £120k;

b)  the current contracts be extended beyond term for a period of 4 months from 1^st December 2023 to 31^st March 2024, to align the contracts with the financial year and grant allocations, at an estimated value of £540k; and,

c)  proceed to procurement for a combined Adults and Young People’s Substance Misuse Service for a period of 5 years with the option to extend for up to 3 years at an estimated annual value of £1,718k and a whole life value of £13,744k. The increased contract value reflected the rise in need and demand and would be contained within the Public Health Grant budget.

In response to a question, the Assistant Director – Public Health said that the supplementary grant was for a period of three years. Indicative amounts had been provided, but were subject to confirmation – however commitment was demonstrated through the National Drugs Strategy.

A Member enquired how competitive the market was for providing this service. The Assistant Director – Public Health highlighted that there were currently two separate contracts, however during the last procurement they had been won by the same provider. Throughout the life of the contracts they had seen the benefits of these being under one management structure, particularly in terms of efficiency and effectiveness. It was noted that there were a number of providers in the market, both for young people and adults. In response to a further question, the Assistant Director – Public Health said they needed to follow due process in terms of when they could engage with providers. If approval was granted to proceed to procurement they would start the engagement – this was not just about getting potential bidders to listen, it was about bringing providers together to network and consider how they could work collaboratively.

In response to questions, the Senior Strategist – Public Health advised that an example of a reason for people not being accepted into the service was that they were not a Bromley resident. They may have come through an Accident and Emergency Department, or other pathway, but would be referred on to the appropriate service. With regards to trends, the Senior Strategist – Public Health advised that they received information on a quarterly basis and Bromley compared very well against the national data across England. It was noted that the current provider was one of the biggest national providers – they compared all of the London boroughs, and Bromley was ranked second in terms of successful completions for the last quarter. It was agreed that comparison data could be circulated to Members following the meeting.

A Member noted concerns in relation to combining the two contracts as the whole life value was a substantial increase on the current contract. A contract of this size would limit the number of providers that could realistically deliver it and could price out small, specialist services, and it was questioned if large providers could tailor their service to meet the local needs. The rise in demand was the reason for the increase in contract value and there were further concerns about what was being done in relation to prevention services. The Assistant Director – Public Health advised that the proposal was to combine the contract, not the services – they wanted to gain the benefits and efficiency of one management structure, which was what was currently happening and there would also be two separate service specifications. In terms of how the market would pan out, it was difficult to say.

The Member further questioned if the contract could be split back down if needed. The Assistant Director – Public Health said that the contract monitoring process would be used to continue to monitor performance, including how the provider worked with partners and ensured there was continuity of care. In terms of providing reassurance the Senior Strategist – Public Health advised that a number of neighbouring boroughs used different providers, and they were confident that more than one bid would be received.

RESOLVED that the Executive be recommended to:

i.)  Approve a variation to the current Adult and Young People’s Substance Misuse Services contracts (paragraphs 3.17 and 3.18) to increase the contract value across both contracts by £120k for the period from 1^st December 2022 to 30^th November 2023;

ii.)  Approve the extension beyond term for the current contracts (paragraph 3.19) for a period of 4 months from 1^st December 2023 to 31^st March 2024 at an estimated value of £540k;

iii.)  Approve the commissioning approach and proceed to procurement for a combined Adults and Young People’s Substance Misuse Service (paragraphs 3.20 to 3.25) for a five year contract commencing 1^st April 2024, with the option to extend for a further three years, at an estimated annual value of £1,718k (whole life value £13,744k); and,

iv.)  Approve delegated authority to Chief Officers in consultation with the Portfolio Holder to authorise an appropriate portion of the Supplemental Substance Misuse Treatment and Recovery (SSMTR) Grant to be drawn down in 2023/24, 2024/25 and to vary the scope and value of the contract accordingly subject to the grant conditions which will be specified by the Office for Health Improvement and Disparities (OHID).

(Councillor Jeal requested that his vote against the recommendations be recorded)