Procurement of a GP extended access service in NHS Nene CCG localities (Lot 1) and a GP out of hours service in Northamptonshire (Lot 2).
Extended access will support GPs to meet rising population demands with additional clinical capacity beyond core hours (8.00 a.m. to 18.30 p.m. Monday to Friday). In addition, the service aims to achieve a positive impact upon patient flow in other service areas, including urgent and unplanned care settings, attributable to patients who cite they are ‘unable to access’ GP appointments, and increasingly meet people’s needs in lower acuity settings, including self-care.
This service aims to stimulate innovative ways of increasing seamless access and capacity to routine and same day to primary care services 7 day service, 365 days a year, including bank holidays. It should provide sufficient routine appointments at evenings and weekends to meet locally determined demand alongside effective access to urgent care services. The core purpose being the stabilisation and sustainability of general practice.
The additional consultation capacity minutes calculated for improved access are in addition to the NHS England Extended Hours Directed Enhanced Service (DES) requirements. Across the Nene CCG footprint 54 practices provide services outside the normal contracted hours as part of the Extended Hours Directed Enhanced Service (DES). This service provides access for patients who are only registered at that practice, who require routine GP appointments outside normal surgery hours allowing them to attend at a time that is more convenient for them. The DES is managed by NHS England and the hours worked under this will not contribute to the hours required to meet the 7 day working requirements associated with this service specification.
The service must:
— be clinically safe,
— provide value for money,
— be sustainable,
— make the best use of and develop the skills of the workforce,
— develop local clinical engagement,
— reduce unnecessary attendances to acute providers of emergency care,
— work collaboratively with the Northamptonshire urgent care system/ partner organisations,
— not increase pressure on the ambulance service,
— be innovative,
— not increase pressure on in-hours GP services,
— seek to align protocols where appropriate to do so.
The out of hours primary medical services are defined as those services provided in the out of hours period (see below) which would be essential services provided by a primary medical contractor, for example at the patient’s own GP practice, during core hours. The Provider would be required to provide these services if it is established that the patient cannot wait to be seen by a practitioner within core hours.
Current out of hours operating times are.
— the period beginning at 6.30 p.m. on any weekday from Monday to Thursday and ending at 8.00 a.m. on the following day,
— the period between 6.30 p.m. on Friday and 8.00 a.m. on the following Monday,
— all bank holidays.
The commissioner expects the provider to ensure that the service is fully active between these times, with the expectation that the provider will engage in a collaborative approach to develop services and access in line with the national and local strategic direction. In all instances there will be an adequate handover to services.
The provider will have a duty to co-operate and comply with other commissioned services designated by the commissioners, including NHS 111.
The provider will ensure systems and processes are in place that balance capacity to demand, minimising avoidable peaks in activity and improving the experience of patients.
The provider will be expected to fully participate in systems and processes required by the commissioners to ensure service preparedness and surge management at times of winter pressures and other periods of high demand and usage.
The provider will demonstrate contingency plans for the management of services during expected and unexpected leave, failure of electronic systems; telephony or other infrastructures, surges in demand, seasonal resilience and emergency incident response (as per NHS standard contract section 30 emergency planning and BI).
The provider will ensure that management arrangements are in place to respond to a range of urgent cases, ensure clinical safety for patients and, where indicated, provide clinical assessment.
The provider will contribute to and evidence the reduction of inappropriate use of services available in the out of hours period through identification and establishment of alternative management plans for frequent service users in consultation with in-hours service provision, EMAS and NHS 111.
The provider will be a member of the CCG’s urgent care in flow and out flow working groups, local A&E delivery board, and any other relevant local and regional groups or networks which are established to review urgent care services or pathways relating to primary care, including NHS 111. The commissioner will endeavour to support the provider in this process. This support will not include any financial remuneration.
The provider will work with all stakeholders and local providers to ensure the service is fully integrated, providing seamless, safe care for the population of Northamptonshire; increasing efficiency and reducing duplication of service delivery.