Stroke is the third most common cause of mortality and the leading cause of disability in England. Each year, approximately 110 000 people in England, have a first or recurrent stroke. Most people survive a first stroke but often have significant morbidity. More than 900 000 people in England are living with the effects of stroke. Stroke mortality rates in the UK have been falling steadily since the late 1960s. The development of stroke unit care, and the further reorganisation of services following the advent of thrombolysis, has resulted in significant improvements in mortality and morbidity from stroke. However, the incidence of stroke may increase in the future as a consequence of growth of an ageing population. Despite improvements in mortality and morbidity, people with stroke need improved access to effective rehabilitation services.
The annual rate of strokes in Leeds is approximately 16 per 10 000 people. The Prevalence of Stroke and TIA in Leeds is 1.7 % as at 2012/13. Review of Dr Foster data reveals that Leeds Teaching Hospitals trust (LTHT) Hospital Stroke Mortality rate is at the national average. (212 observed versus 206 expected).
Leeds with a population of 751 500 (Census for Leeds 2011) equates to approximately 1 202 strokes per annum, (based on the 203/14 full year effect) this is broken down between the three CCGs as follows:
Leeds North 290 admissions for stroke.
Leeds South and East 509 admissions for stroke.
Leeds West 403 admissions for stroke.
The aim of the service is to provide a follow up assessment service (between 4 -8 months) after initial admission for stroke. The service will be a local, domiciliary service with staff qualified to appropriate levels of skill and experience including basic observations of pulse and blood pressure. There is a requirement for staff to have excellent communication skills and an understanding of working with people with complex physical, psychological and communication needs.
Patients will be identified for a follow up assessment through the Sentinel Stroke National Audit Programme (SSNAP). An assessment of the patient's needs will be undertaken using the GM-SAT assessment tool. (See Appendix A). The Provider will be required to be registered with SSNAP to be able to input the data from the assessment into the SSNAP core data set section relating to the follow up assessment. (www.strokeaudit.org) A baseline of eligible people will be established at the commencement of the service with ongoing data completeness. The service will be provided to people within their own homes over 6 days per week to ensure flexibility for carers and service users. An assessment of the identified needs will be available for each person with signposting, where indicated to the relevant health, advisory or social care partner and summary report to the patient's GP.
The successful providers(s) will be offered a standard NHS contract. The contract is a block contract and there will be the opportunity to review activity levels within the duration of the contract.
The contract will be for an 18 month period following mobilisation and there will be the option for the CCG to extend to this for up to 2 additional years depending on outcomes and funding.
A service specification, the draft contract particulars, Service conditions and General conditions along with the electronic application form can be found online at www.nhssourcing.co.uk and applications will be received until 29.10.2014.
As the procurement falls under Part B of Schedule 3 of the Public Contracts Regulations 2006, it is only mandatory for the procurement to comply with Regulation 5 (2).