Diabetic Eye Screening Programmes for Bath and North East Somerset, Swindon and Wiltshire and Dorset Contract Award

NHS England and NHS Improvement South West (The Commissioner) sought to re-commission a Diabetic Eye Screening Programmes (DESP) to deliver screening to the eligible populations of Bath and North East Somerset, Swindon and Wiltshire (BSW).

The eligible population includes patients over the age of 12 diagnosed with diabetes and registered with, or eligible to be registered with a GP, as well as individuals within prisons, secure units and the armed forces.

The aim of the DESP is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight threatening diabetic retinopathy.

This will be achieved by delivering an evidence-based service that:

• Identifies the eligible population and ensures effective delivery with maximum coverage
• Is safe, effective, high quality, externally and independently monitored, and quality assured
• Leads to earlier detection, appropriate referral, effective treatment and improved outcomes
• Is delivered and supported by suitably trained, competent and qualified clinical and non-clinical staff who, where relevant, participate in recognised ongoing continuing medical education (CME), continuous professional development (CPD) and quality assurance (QA) schemes
• Has audit embedded in the service
• Works effectively with other stakeholders to ensure the care pathway is smooth and efficient.

There are three key elements of service delivery, namely:

• Call/recall for all people with diabetes invited for routine digital screening - this is currently undertaken on an annual basis but screening intervals are likely to extend to two years for people at low risk during the contract term in line with national guidance
• Digital surveillance where individuals need more frequent screening
• Slit lamp bio-microscopy (SLB) for those individuals where normal photography is inappropriate (e.g. those having cataracts).

Optical Coherence Tomography (OCT) does not form part of this Contract at this time, though this position may change over the life of the contract in line with national guidance.

The Contract term will be 5 years, with an option to extend for a further 3 years at the sole discretion of the Commissioner. The Contracts will commence on 1st April 2022.

The Services have been commissioned using the national service specification for DESP Services, localised where appropriate.

The 8 year estimated expected contract value, based on predicted activity levels is £11,311,233.60.

The Contract will operate on a hybrid basis with a fixed "block" element based upon the average uptake of routine screening in the eligible population for the last 2 years plus a variable element for digital surveillance and SLB and a further variable element to incentivise routine screening uptake to 85%. Variable elements will be paid according to activity undertaken.

The Commissioner's ambition through the financial model is to encourage uptake of DESP to achieve or exceed the national achievable target of 85% uptake in routine screening (DE1).

National changes to screening frequency for low risk individuals are expected to be implemented during the contract term which will have an impact on activity. The subsequent impact on contract values will be agreed between the Provider and the Commissioner via contract variation.

This procurement was carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioners. Additional information: The services are healthcare services falling within Schedule 3 to the Public Contracts Regulations 2015 ("the Regulations") which are not subject to the full regime of the Regulations, but is instead governed by the "Light Touch Regime" contained within Chapter 3, Section 7 of the Regulations (Regulations 74 to 77).

NHS England and NHS Improvement South West (The Commissioner) sought to re-commission a Diabetic Eye Screening Programme (DESP) to deliver screening to the eligible population of Dorset.

The eligible population includes patients over the age of 12 diagnosed with diabetes and registered with, or eligible to be registered with a GP, as well as individuals within prisons, secure units and the armed forces.

The aim of the DESP is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight threatening diabetic retinopathy.

This will be achieved by delivering an evidence-based service that:

• Identifies the eligible population and ensures effective delivery with maximum coverage
• Is safe, effective, high quality, externally and independently monitored, and quality assured
• Leads to earlier detection, appropriate referral, effective treatment and improved outcomes
• Is delivered and supported by suitably trained, competent and qualified clinical and non-clinical staff who, where relevant, participate in recognised ongoing continuing medical education (CME), continuous professional development (CPD) and quality assurance (QA) schemes
• Has audit embedded in the service
• Works effectively with other stakeholders to ensure the care pathway is smooth and efficient.

There are three key elements of service delivery, namely:

• Call/recall for all people with diabetes invited for routine digital screening - this is currently undertaken on an annual basis but screening intervals are likely to extend to two years for people at low risk during the contract term in line with national guidance
• Digital surveillance where individuals need more frequent screening
• Slit lamp bio-microscopy (SLB) for those individuals where normal photography is inappropriate (e.g. those having cataracts).

Coherence Tomography (OCT) does not form part of this Contract at this time, though this position may change over the life of the contract in line with national guidance.

The Contract term will be 5 years, with an option to extend for a further 3 years at the sole discretion of the Commissioner. The Contracts will commence on 1st April 2022.

The Services have been commissioned using the national service specification for DESP Services, localised where appropriate.

The 8 year estimated expected contract value, based on predicted activity levels is £10,985,831.92.

The Contract will operate on a hybrid basis with a fixed "block" element based upon the average uptake of routine screening in the eligible population for the last 2 years plus a variable element for digital surveillance and SLB and a further variable element to incentivise routine screening uptake to 85%. Variable elements will be paid according to activity undertaken.

The Commissioner's ambition through the financial model is to encourage uptake of DESP to achieve or exceed the national achievable target of 85% uptake in routine screening (DE1).

National changes to screening frequency for low risk individuals are expected to be implemented during the contract term which will have an impact on activity. The subsequent impact on contract values will be agreed between the Provider and the Commissioner via contract variation.

This procurement was carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioners. Additional information: The services are healthcare services falling within Schedule 3 to the Public Contracts Regulations 2015 ("the Regulations") which are not subject to the full regime of the Regulations, but is instead governed by the "Light Touch Regime" contained within Chapter 3, Section 7 of the Regulations (Regulations 74 to 77).