NHS South Yorkshire ICB - Severe Mental Illness Physical Health Check Service.

The Authority is of the view that it is in the best interest of Doncaster residents to make a direct award of contract to Primary Care Doncaster Limited for a further 6 months for the following reasons:<br/><br/>• Whilst the service is performing well and is achieving national targets, an initial review highlighted that there were several issues with the existing pathway and processes surrounding interoperability and shared care. Additional time is required to evaluate these concerns and understand what is needed as part of a potential future pathway. <br/><br/>• A review needs to be undertaken to consider wider existing service provision, which will look to understand the Primary Care Network and General Practices roles within this service. This will take into consideration the Quality outcomes Framework (QOF) and the Anticipatory Care Framework (ACF).<br/><br/>• A full evaluation and options appraisal will be developed which will support future procurement intentions. Following this, if the model will look to change significantly, the 6-month extension will ensure that an appropriate exit or transfer strategy is developed, and patients will not be left without provision. <br/><br/>Further rationale supporting these points is:<br/><br/><br/>• The service is offering support to a vulnerable cohort of patients, those with an SMI die 15-20 years younger than the average population and this service is supporting in the prevention of early mortality and supports in reducing health inequalities. Therefore, any disruption to service needs to be considered carefully and timely ensuring that any changes made are in the best interests of those affected.<br/><br/>• The recently published Anticipatory Care Frameworks sets out a responsibility for holistic care planning with a focus on the Core20PLUS5 cohorts which includes SMI patients. Further work needs to be undertaken to understand how this can be incorporated into a future pathway. <br/><br/>• A number of issues have arisen as part of an initial review of the service which have highlighted disparities between the primary care SMI list and the list held by the service, further work needs to be undertaken to audit the lists and consider new processes as part of any future intentions. <br/><br/><br/>Summary<br/><br/>Considering the potential for improvements identified through the initial review, a 6-month extension for the service allows for further evaluation, development of comprehensive options, and potential efficiency savings in the long term. Additionally, the publication of the Anticipatory Care Framework highlights the role of Primary Care Networks (PCNs) in supporting complex cohorts, including those with an SMI. Exploring collaboration with PCNs through the QoF and Anticipatory Care Framework may provide opportunities, ensuring continuity of care and minimising negative impacts. Therefore, this extension allows time for implementing a new pathway and avoiding rushed re-procurement without sufficient remodelling or efficiency considerations.