Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (or encephalopathy) (ME) Service

Chronic Fatigue Syndrome (CFS) and Myalgic Encephalomyelitis (or encephalopathy) (ME) Service

Contracting Authority: NHS Hampshire, Southampton and Isle of Wight Clinical Commissioning Group

The Contracting Authority is entering into a contract with South Coast Fatigue for the reasons detailed below.

The proposed contract is for a period of 2 years commencing 1st April 2022 with the option to extend for a further 24-month period.

The Authority shall enter into a contract with the incumbent provider (South Coast Fatigue) to ensure continuity of services relying upon a Regulation 32 exemption of no response/no requests to participate have been submitted in response to PIN 2022/S 000-001760.

Service description:

The Chronic Fatigue Service (CFS) and Myalgic Encephalomyelitis (or encephalopathy) (ME) service provides specialist assessment, therapeutic intervention and lifestyle management advice for people suffering from mild to moderate CFS and ME. This includes advice to support health care professionals, service users and carers. Prior to the recent CCG merger the contract was hosted by West Hampshire CCG and commissioned collaboratively between the following CCG areas: West Hampshire, North Hampshire, South Eastern Hampshire, Fareham and Gosport and Southampton City. IOW CCG has a small separate contract with South Coast Fatigue.

Due to the merging of CCGs in April 2021 it is proposed to merge the two contracts into one to incorporate the IOW into a single HIS CCG contract, please note the IOW element of the Contract is £20,000 per anum.

Strategic Objectives:

In line with the NHS Long Term Plan, and the Community Mental Health Transformation Programme the HSIOW CCG is pursuing the development and implementation of an effective network of community mental health services. The primary aims are to:

• ensure that at the start of a person's recovery, wherever and however a person accesses care they are met with compassion, understanding, and supported with both their physical and mental wellbeing.
• build teams around communities that are close to people's homes, by working with our partners including the voluntary sector, making sure people's recovery is close to their personal support networks.
• provide people who are working across these physical and mental health services with the right support and training, making sure we have creative career options across the area.

The NHS Long Term Plan describes the vision and ambition for patients to have more options, better support, and care at the right time in the optimal care setting.

Commissioning Intentions:

The commissioner's intention is to integrate the two existing contracts covering the Hampshire mainland and the Isle of Wight into a single contract. The scope of the IOW contract is £20,000 per annum.

The contract will include the small numbers of patients aged over 65 who are currently managed on an individual basis to enable the service to become all age.

The justification for a fixed term contract is on the basis of patient need; quality; and efficiency:

Over the lifetime of the contract the service demonstrated strong evidence of improvements for individuals in the primary outcome measures of fatigue and physical function. Evidence of improvement is also strong for the secondary outcome measures of depression and anxiety and there was some evidence for improvement in pain. Almost all patients (91.5%) reported a positive change in their health and wellbeing according to the Clinical Global Impression questionnaire.

Changes in key outcomes measured between admission and discharge:

91% of individuals rate their overall experience with South Coast Fatigue as excellent with the remainder rating it as very good or good. South Coast Fatigue is a local company specialising in the treatment of CFS/ME, providing a recovery focused multi-disciplinary approach.South Coast Fatigue has successfully been providing a service in Hampshire, Southampton, and the Isle of Wight for the last 7 years and has demonstrated evidence of improvement following treatment. This is a highly specialised, low volume service and previous competitive procurement resulted in no other bidders for the service.

The Covid pandemic resulted in emergency measures resulting in a decision to delay competitive tendering and further supporting the decision to direct award in this case.

This has been in consideration of:

• The current national requirement to prioritise response to the pandemic, urgent and emergency care and recovery of elective services
• The necessity of ensuring that the local population has continuity of service
• The material changes to the existing CCG/ICS structure commencing 1 July 2022 with potential impact on workforce and governance timelines.

Benefits of remaining with the current provider:

Consistency in service provision in keeping the current provider. South Coast Fatigue are known and trusted by patients and have well-established clinical relationships across the system including GPs, and the acute Trust.South Coast Fatigue are performing well as a provider as evidenced by their KPI's and quarterly reporting to the CCG

Known service that has already shown it can be flexible as we move into the uncertain future of a surge in demand for all community services.Current provider can maintain and build upon existing relationships with other providers and services.

Enables a substantial opportunity to re-evaluate the current patient demand, particularly with regard to long-covid, that falls under the prevention and proactive care remit and redesign where necessary along with the aforementioned programmes of work. Maintain stability in the medium term, to ensure the best possible outcomes and experience for our patients.

Benefit from established clinical relationships that have already fostered confidence in service delivery.

Support patient confidence, with a provider already known to local patients.For further information regarding this direct a…