AQP Adult Direct Access MSK Physiotherapy service and First Contact Practitioner (FCP) MSK Assessment Service

NHS Frimley ICB ("the Commissioner") sought to commission an AQP Adult Direct Access MSK Physiotherapy service and First Contact Practitioner (FCP) MSK Assessment Service, for patients in the North-East Hampshire & Farnham geographical locality of Frimley ICB. A summary of the purposes and objectives of the services are below.

AQP Adult Direct Access MSK Physiotherapy service: Patient population covered is North-East Hamsphire and Farnham place. Referrals are via GP. The referring GPs prioritise patients as either routine or urgent. The provider carries out an initial face-to-face clinical assessment with the patient, during which a treatment plan is discussed and agreed. For referrals accepted into the service, a package of care is provided consisting of the necessary treatment required to meet the individual clinical needs of the patient. This may include but is not limited to: advice & education, provision of literature, acupuncture, manual therapy, electrotherapy, exercise programmes, soft tissue mobilisation or back care advice. Follow-ups are provided. Group exercise programmes are permitted as part of the treatment.

First Contact Practitioner (FCP) MSK Assessment Clinic: A community-based physiotherapy service benefitting patients with musculoskeletal conditions, who are able to be assessed and treated by a physiotherapist without an initial GP appointment. The service is delivered from participating GP Practice locations within the North-East Hampshire and Farnham locality of Frimley ICB. Patients with musculoskeletal conditions will be seen and assessed by the extended scope practitioner (ESP) who will make good use of pre-existing services such as exercises courses.

Patients would expect to be seen within five days, preferably within one to two days of them first contacting the practice. Following assessment the ESP will, as appropriate:

• Treat or advise on the day and provide a suitable exercise sheet and management plan
• Recommend a locally available exercise course
• Refer on to the existing AQP Provider for an appropriate course of treatment.
• Perform a joint injection (knee, shoulder, hand or wrist) working under a protocol agreed with Salus.
• Refer for imaging (x-ray, ultrasound, MRI) subject to countersignature by a GP
• Refer to a secondary care orthopaedic consultant subject to countersignature by a GP
• Identify problems that are more likely to have a cause which comes under the heading of rheumatology and request appropriate blood tests using a locally agreed protocol. These cases will be discussed with a GP
• Identify any "red flag" symptoms and discuss with the duty doctor on the day.

The Commissioner is directly awarding a contract to the existing provider Premier Physical Healthcare Limited in accordance with the criteria outlined in Regulation (9) of the Health Care Services (Provider Selection Regime) Regulations 2023. The total value of the contract for the initial one-year contract term is £259,814.26. The full lifetime contract value (one year + optional one year extension) is £521,187.41. The one-year contract period will commence on the 1st April 2024.

This procurement has been carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioners. Additional information: Evidence that Premier Physical Healthcare have satisfied the existing 23/24 contract to a sufficient standard according to the detail outlined in the contract: they provided all of the required documentation, information and policies for the existing contract. They have followed the contractual service specification, not deviated from Frimley ICB Safeguarding requirements, charged the correct local prices as per the contract, issued invoices correctly in accordance with the Frimley ICB process, complied with Quality reporting requirements, and followed Schedule 6A reporting requirements. They have complied with/not fallen foul of the 23/24 NHS Standard Contract (Shorter Form) Service Conditions, including Service Conditions in relation to the following: service standards, co-operation, information requirements, safeguarding, payment terms and quality requirements. They have also complied with/not fallen foul of the 23/24 Shorter Form General Conditions, including those relating to: liability & indemnity, assignment & sub-contracting, and Information Governance. The new contracting arrangements are based on a rollover of the previous contracting arrangements/schedules which the provider has already satisfied/complied with to a high standard, and so the provider will highly likely to be able to satisfy the new contract to a sufficient standard.