NHS England South West - Diabetic Eye Screening Programmes for Cornwall, Devon, Somerset, Gloucestershire and Bristol, North Somerset, South Gloucestershire (BNSSG)

Description

NHSE South West (The Commissioner) sought to re-commission five Diabetic Eye Screening Programmes (DESP) to deliver screening to the eligible populations of Cornwall and Isles of Scilly (Lot 1), Devon (Lot 2), Somerset (Lot 3), Gloucestershire (Lot 4), and BNSSG (Lot 5). Adverts were placed on Contracts Finder and the Find a Tender Service and an Invitation to Tender (ITT) process, based on the Open procedure, was undertaken during summer / autumn 2023 to identify the Most Economically Advantageous Tender and therefore determine the incoming provider for each Lot.  

The eligible population includes patients over the age of 12 diagnosed with diabetes and registered with, or eligible to be registered with, a GP in the lot area as well as individuals within prisons, secure units and the armed forces.

The aim of the DESP is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment, if necessary, of sight threatening diabetic retinopathy. 

This will be achieved by delivering an evidence-based service that:
•	Identifies the eligible population and ensures effective delivery with maximum coverage
•	Is safe, effective, high quality, externally and independently monitored, and quality assured
•	Leads to earlier detection, appropriate referral, effective treatment and improved outcomes
•	Is delivered and supported by suitably trained, competent and qualified clinical and non-clinical staff who, where relevant, participate in recognised ongoing continuing medical education (CME), continuous professional development (CPD) and quality assurance (QA) schemes 
•	Has audit embedded in the service
•	Works effectively with other stakeholders to ensure the care pathway is smooth and efficient

There are 3 key elements of service delivery, namely:
•	Call/recall for all people with diabetes invited for routine digital screening; this is currently undertaken on an annual basis, but screening intervals are likely to extend to 2 years for people at low risk during the contract term, in line with national guidance
•	Digital surveillance where individuals need more frequent screening
•	Slit lamp bio-microscopy (SLB) for those individuals where normal photography is inappropriate (e.g. those having cataracts).

Optical Coherence Tomography (OCT) does not form part of these Contracts at this time, though this position may change over the life of the contract in line with national guidance. 

Contracts have been awarded as follows for a term of 6 years, with an option to extend for a further 3 years at the sole discretion of the Commissioner: 
•	Lot 1: Royal Cornwall Hospitals NHS Trust
•	Lot 2: InHealth Intelligence Ltd
•	Lot 3: Somerset NHS Foundation Trust
•	Lot 4: Gloucestershire Hospitals NHS Foundation Trust
•	Lot 5: InHealth Intelligence Ltd

The Contracts are due to commence on 1st April 2024.

Additional information: The 9 year estimated contract values, based on predicted activity levels, are: 
Lot 1 = £9,663,708
Lot 2 = £24,764,019
Lot 3 = £13,741,086
Lot 4 = £11,373,272
Lot 5 = £15,547,780

The Contracts will operate on a hybrid basis with a fixed "block" element based upon the actual activity for routine screening in 2021/2022 plus a variable element for digital surveillance and SLB and a further variable element to incentivise uptake to 85%. Variable elements will be paid according to activity undertaken. 

The Commissioner's ambition through the financial model is to encourage uptake of DESP to achieve or exceed the national achievable target of 85% uptake in routine screening (DE1).

The Services have been commissioned using the national service specification for DESP Services, localised where appropriate. 

National changes to screening frequency for low risk individuals are expected to be implemented during the contract term which will have an impact on activity. The subsequent impact on contract values will be agreed between the Providers and the Commissioner via contract variation.

This procurement has been carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioners.

The services are healthcare services falling within Schedule 3 to the Public Contracts Regulations 2015 ("the Regulations") which are not subject to the full regime of the Regulations, but is instead governed by the "Light Touch Regime" contained within Chapter 3, Section 7 of the Regulations (Regulations 74 to 77).