Agenda item

Report of the Director of Public Health. Communities and Prosperity (PH/24/05) seeking authority to recommission Sexual and Reproductive Health Services, attached.

An Impact Assessment has been prepared for the attention of Members and is also available on the web at - https://www.devon.gov.uk/impact/sexual-and-reproductive-health-recommissioning

RESOLVED

(a) that the joint re-procurement of sexual and reproductive health services by Devon County Council and Torbay Council be approved; and

(b) that the Director of Public Health, Communities & Prosperity be given delegated authority to approve contract award recommendations and enter into the new contractual arrangements, in consultation with the Cabinet Member for Public Health, Communities and Equality, the Chief Executive and the S151 Officer.

(Councillors Biederman, Leaver and Whitton attended in accordance with Standing Order 25(2) and spoke to this item).

The Cabinet considered the Report of the Director of Public Health. Communities and Prosperity (PH/24/05) which sought authority to recommission Sexual and Reproductive Health Services, circulated prior to the meeting in accordance with regulation 7(4) of the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012.

The Cabinet noted that the Health and Social Care Act 2012 stated that Local Authorities had a statutory responsibility to provide open access sexual health services for everyone in their area, and it formed part of the conditions attached to the Public Health Grant. The requirements covered free testing and treatment for sexually transmitted infections (STI); notification of sexual partners of infected persons; free contraception; and ensuring reasonable access to all methods of contraception.

The Council’s current contracts for the provision of these services expires on 30 June 2025 and in line with the previous procurement exercise, the Council was working with Torbay Council to create a single service specification to ensure consistency in provision of service across Devon. In addition, the Public Health grant had reduced by over 25% in real terms over the past 7 years, against a backdrop of rising infections and increasing demand for some services.  The public health team had benchmarked and spoken to different local authorities to gather evidence on the different service delivery models. The benchmarking indicated that generally, Devon had better sexual and reproductive health outcomes and the costs were generally higher or similar when compared to our statistical comparator local authorities. 

The Report also commented on the recent report by the UK Health Security Agency (UKHSA) (Sexually transmitted infections and screening for chlamydia in England: 2022 report - GOV.UK (www.gov.uk)) which highlighted a post-pandemic increasing trend in sexually transmitted infections in England which emphasised the need for Devon to be well prepared to respond to challenges locally. 

The Cabinet noted the intention to develop a specification, which would be reinforced contractually, that shifted focus (and resource) away from activity in specialist services and into preventative activity and to self-management and providers would be invited to set out how they would deliver this through a combination of a universal digital offer, a range of local services (place-based health provision), specialist sexual health services, and education and training.

The Report outlined the Services provided currently and highlighted that the changes being proposed did not materially change the types of services being delivered but would seek to organise, deliver, and develop them in new ways to keep pace with changing need and expectations.

The Health and Care Act 2022 introduced a new procurement regime for selecting providers of healthcare services called the Provider Selection Regime (PSR), therefore the re-procurement had to be compliant with this and assess potential providers against quality and innovation; value; integration, collaboration and service sustainability; improving access, reducing health inequalities and facilitating choice; and social value.

The timeline was to launch the procurement in July 2024 to ensure contract award recommendation and contract award no later than January 2025, leaving time to mobilise the new arrangements before being fully operational by 1^st July 2025.

There had been a number of engagement exercises over the last 18 months, and this was outlined in full at section 6 of the Report as well as highlighting that the proposed service model aligned well with the Strategic Plan.

The proposals would need to be met from within the ring-fenced Public Health grant and it was anticipated contracting with a provider (or providers) for ten years, through a five-year contract (to 30 June 2030), with the option to extend for up to a further total 5 years. The total budget could be in the region of £50 million over the 10 years.

An Impact Assessment had been prepared for the meeting and was also available on the web at - https://www.devon.gov.uk/impact/sexual-and-reproductive-health-recommissioning. This highlighted that public health programmes were targeted to people and communities in greatest need to minimise an adverse impact on health inequalities. It was possible that there would be negative impacts to some people because of the changes from the current to the proposed Integrated Sexual and Reproductive Health service, and the Report and Impact Assessment outlined the mitigations accordingly.

The matter having been debated and the options and alternatives and other relevant factors (e.g. financial, sustainability and carbon impact, risk management, equality and legal considerations and alignment with the Council’s Strategic Plan) set out in the Director’s Report having been considered:

it was MOVED by Councillor Croad, SECONDED by Councillor Hart, and

RESOLVED

(a) that the joint re-procurement of sexual and reproductive health services by Devon County Council and Torbay Council be approved; and

(b) that the Director of Public Health, Communities & Prosperity be given delegated authority to approve contract award recommendations and enter into the new contractual arrangements, in consultation with the Cabinet Member for Public Health, Communities and Equality, the Chief Executive and the S151 Officer.