The council is reviewing current spend against services in line with efficiency savings and has identified a need to review the sexual health service provided by Herefordshire Integrated Sexual Health for the financial year 2018/19 and beyond.

The council is in discussion regarding reasonable adjustments to the budget with the current service provider to achieve savings of approximately £300,000, reducing the annual budget from the current spend of £1,389,675 to £1,089,675.  This reduction in budget incorporates the cost of primary care prescribing of contraception by GPs, which has over the last two financial years been paid by the council in addition to the block contract payments, but which now is required to be administered and paid directly by the provider.

The council has recognised that the service is in the final year of the initial three-year contract period, which was awarded following an open procurement exercise, and that the contract end date is currently 30 November 2018.  Approval is therefore being sought for the two-year extension option within the current contract to be applied, moving the final end date to 30 November 2020.  This allows for a phased implementation of the proposed savings of £120,000 in the first financial year and £180,000 in the second financial year.  This will also assist with service continuity and provide planning time to consider the future following the ending of the public health grant in 2020.

Should it not prove possible to agree this savings target with the current provider, then a re-procurement exercise will be required with immediate effect.

That:

(a)         the extension of the contract to 30 November 2020 is approved to maintain service continuity and allow for the £300,000 efficiency savings to be delivered over a phased period;

(b)        authority is delegated to the director for adults and wellbeing to initiate a competitive procurement exercise if an agreement cannot be reached with the current service provider in regard to either the efficiency savings target identified or the proposed extension period;

(c)   subject to the completion of a tendering process, authority to award a contract for an integrated sexual health service,  is   delegated to the director of adult services, in consultation with the s151 officer and Cabinet Member for Health and Wellbeing.

1.           Take no action to reduce current spend on sexual health services. This is not recommended as the council is required to address current spending in line with the medium term financial strategy and ahead of the cessation of the public health ring fenced grant in 2020 which will make the current spend on these services potentially unsustainable.  The council needs to respond to this financial forecast now in order to maintain future service delivery.

2.           Allowing the contract to expire without ensuring sufficient provision going forward is not recommended. The council has a legal obligation to ensure adequate service provision for sexual health as set out in the Health and Social Care Act 2012 and The Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013

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