Agenda item

B&NES, Swindon & Wiltshire Clinical Commissioning Group (BSWCCG) Governing Body and B&NES Council, as joint commissioners, have requested a report setting out an options appraisal to help decide whether it wishes to extend the Virgin Care contract. 

This is a seven year contract from 2017/18 to 2023/2024 with the option for BSWCCG and B&NES Council to extend the contract term by three years, taking the contract term to 2026/2027.  Virgin Care would need to be notified of the decision to extend or not to extend the contract by no later than end of March 2022.

The original contract expiration date is the end of contract year seven and this point is deemed to be an ordinary exit date with the option to extend for a further three years.

If a decision were taken to exercise the option to extend the contract term the Co-ordinating Commissioner (B&NES Council) must give written notice to Virgin Care no later than 24 months prior to the original expiry date (end of year 5 2021/2022 – March 2022 latest date). The option to extend the contract term by three years can only be taken once.

Councillor Alison Born introduced the report and made the following statement:

“This report sets out an options appraisal to help the Council and CCG, as joint commissioners, decide whether they wish to extend the Virgin Care contract for the delivery of integrated health care, social care and public health services in B&NES.

By way of background, the contract for community health and Care services for Bath and North East Somerset was awarded to Virgin Care in 2016 at the end of a comprehensive engagement and commissioning process known as “Your Care Your Way”.

The contract was for an initial 7 years with the option to extend for a further 3 years. A decision regarding the extension must be made and communicated to Virgin Care by the end of March 2022. The decision to extend is a joint one with the CCG as it is a shared contract. The potential extension will take the term of the contract up to the end of March 2027.

A review of the services provided by Virgin Care has been undertaken and that information, together with an evaluation of the current health and social care landscape has informed the detailed options appraisal required for the Cabinet and the CCG Board to make an informed decision. The CCG is also meeting this week to consider the options paper.

The 3 options considered are:

Option 1 – To extend the contract with no changes

Option 2 – To not extend the contract

Option 3 – To extend the contract with the statutory functions of CHC and Adult Safeguarding returning to the CCG and the Council

Option 3 is recommended for the following reasons:

-  Virgin Care has generally provided good services, more recently (in the context of the pandemic) in very challenging circumstances and has worked constructively with partners across health and social care.

-  It has also made some significant improvements to services since it took on the community contract in 2017, examples include the introduction of electronic care records, developments within stroke services and district nursing.

-  This is a particularly challenging time for health and social care and services must focus on reform and recovery from the pandemic.

-  NHS commissioning is currently transitioning to the new integrated care arrangements and further disruption within provider services would be destabilising at this time. It should be done if it is necessary, but it isn’t. It is also unlikely that there will be other providers with the right experience able to take this work on within the timescale required.

-  We must keep the needs of service users foremost in our minds and It makes most sense at this time to opt for stability and continuity by extending the contract for a further 3 years with the withdrawal of the statutory services and with the requirement that Virgin Care makes improvements in some areas such as waiting times, length of stay and in the provision of the reablement service.

These 3 options have been considered and discussed by the Children, Adults, Health and Wellbeing Scrutiny panel, where option 3 received unanimous, cross -party support. The contract extension allows time for a very thorough process to determine the services that will be commissioned in 2027 and that work will begin once this decision is made”.

Councillor Alison Born moved the recommendations.

Councillor Richard Samuel seconded the motion and made the following points:

“The original contract signed in 201718 allowed for a contract extension of three years. Extension subject to satisfactory review on performance.

Seven years expires in 2023/24 and the decision to extend or otherwise has to be made in sufficient time to allow for contract retendering were that to be the preferred option. That point is now as Virgin have, under the contract, to be given 24 months’ notice of that decision. My understanding is that performance has been satisfactory. In advancing the recommendation other factors are also relevant for the council although not strictly part of the decision. It will have escaped no-one’s notice that the council’s revenue budget is under considerable pressure due to covid and that there is a considerable cost to a retender. It is also the case that major changes in the arrangements for adult social care are in the pipeline. In these circumstances it is my view that a retender exercise would place additional demands on already stretched officer capacity and that given the acceptable performance on this contract it is more prudent to extend it than to embark on a costly tender process.

I therefore second the recommendations in this report accordingly”.

Councillor Dine Romero stated that Virgin Care have been responsible for a wide range of services since 2017 including the school immunisation programme. They have stepped up to the plate during the pandemic. Councillor Romero added that she supported the motion and did not think it was the time to make extreme changes.

RESOLVED (unanimously) to recommend that the Cabinet on 11^th November 2021:

1.1  Approve Option 3 - Extend the contract term for the 3 year period (until 31^st March 2027) but with identified services removed from block contract and/or improvement trajectories for identified services and delegate to Suzanne Westhead, Director Adult Social Care (DASS) in consultation with Cllr Born, Member for Adult Services authority to serve notice to extend the contract once assured that the total price for the contract as varied is agreed and affordable.

1.2   Note that an extra-ordinary B&NES, Swindon and Wiltshire Clinical Commissioning Group (BSWCCG) Governing Body meeting has been convened for a decision to be taken on 11^th November 2021, to ensure a joint decision is taken in public on the same day, for the recommendation of Option 3 - Extend the contract term for the 3 year period (until 31^st March 2027) but with identified services removed from block contract and/or improvement trajectories for identified services.

1.3  Note the following risks:

·  Contractual deadline of 31^st March 2022 to inform Virgin Care of the decision to extend the contract for the 3 year term or not – limited time for slippage in the decision making process.

·  Consideration of the current contractual interdependencies between heath care and social care commissioning and service delivery.  The Council and CCG have a long history of integrated commissioning arrangements with a number of services which have jointly agreed service specifications to deliver integrated services, for example reablement.

·  As joint commissioners both B&NES Council and BSWCCG must agree on the option that is decided upon – if an agreement cannot be reached this will cause further delay in the decision making process.