This report seeks the approval of a 1 year extension to the current contractual arrangement for the delivery of NHS Healthchecks to 31 March 2021.

It is recommended that the council directly award a contract extension to Taurus Healthcare to continue to provide NHS Health Checks, including identification and invitations to the eligible population (residents aged 40-74 and not on existing disease registers).  This is based on Taurus Healthcare, as the GP Federation, being the only body currently capable of accessing GP practice lists and able to utilise the day-to-day contact and interaction GPs already have with the patient base.

A contract extension is also recommended to allow time for the establishment of the new Primary Care Networks.  The intention will be to work with Taurus Healthcare as a key strategic partner and as part of a multi-disciplinary steering group to ensure relationships are developed with primary care network directors to support the improvement of the health check service delivery and targeting.  

The existing contract is due to expire on 31/03/2020. The recommendations being made take account of the evidence base, lessons learnt following review of the current service provision and acknowledgement of the development work taking place to establish Primary Care networks throughout the county.

That:

(a)  a 1 year contract extension be awarded to Taurus Healthcare at a value of up to a maximum of £200,000 to provide NHS Health Checks in the period 1 April 2020 to 31 March 2021.

1.    Allow the existing contract for NHS Health Checks to expire on 31 March 2020 and the service to cease. This option is not recommended as this service is key to improving the health of the local population and is a mandated function of upper tier councils.

2.    There is potential for the service to be provided using a delivery model of any qualified provider (AQP).  This option is not currently recommended, as a previously commissioned model of this type did not meet expected targets as most of the approved providers were unable to market and deliver services in the county.  This is because GP practice lists are the only available data source for inviting the eligible population to a health check. To date it has not been possible to secure a suitable process for accessing this information through data sharing agreements.  Whilst this could be challenged, the current timing of this award during a period of change for primary care and the development of primary care networks creates a challenging environment for the renegotiation of this.  As a consequence, GP organisations are the only practical option for delivery of the service, all GP practices in Herefordshire use Taurus Healthcare as their federation and vehicle for contractual arrangements and many smaller practices will continue to do so throughout the development of Primary care Networks.

3.    To invite competitive tender to contract with a single external provider.  This option is not recommended because evidence from the previous AQP model has shown that securing a suitable process for data sharing of the eligible population lists from GP practices has been ineffective, following evaluation of available provision and discussion with neighbouring counties it is clear that there is a very limited market for competitive tender.  The majority of areas contract directly with GP practices or via federations, those with the highest performance contract directly with practices.