Primary Care Sheffield Limited & NHS South Yorkshire ICB Tele-dermatology USC Emergency Provision 2024/25

The relevant authority, NHS South Yorkshire Integrated Care Board (SYICB) believe this award of a dermatology imaging contract, to Primary Care Sheffield Limited, is urgent.<br/><br/>Following the regulations below from the Provider Selection Regime (PSR) the contract has been awarded under the Health Care Services Regulations 2023.<br/><br/>Regulation 14(2)(a) of the Provider Selection Regime: The authority considers that the award must be made urgently<br/><br/>The authority considers that the award must be made urgently.<br/>Sheffield Teaching Hospitals have recently been under increasing national scrutiny as the worst performer in the country for the Faster Diagnosis Standard in skin cancer which is being correlated with them being the only provider without a comprehensive tele dermatology service. Tier 1 conversations have requested urgent action to recover this position. <br/><br/>Some short term waiting list initiatives have been implemented to improve the position but this remains fragile due to ongoing capacity constraints and there still being insufficient capacity to match demand. There is well-recognised seasonal variation with skin cancer referrals leading to increased referrals over summer when the service is often most stretched for capacity. There are also concerns regarding waiting times for non-skin cancer conditions which have a serious quality of life implication. Awarding the teledermatology contract will allow consultant led triage of the urgent suspected cancers ensuring that the referrals into STHFT are limited to those definitely requiring secondary care input and releasing capacity to manage the whole PTL. <br/><br/>Regulation 14(2)(b): The reason for the urgency was not foreseeable by and not attributable to the relevant authority<br/>Less than 6 months ago STH were performing above the FDS target for skin and whilst performance declined during the winter it was not expected that this would drop as significantly below target as it did and continuing on a downward trajectory. A local incentivisation scheme was implemented to ensure dermatology image capture in primary care but this has not yielded the productivity gains that have been demonstrated by utilisation of a tele-dermatology provider.<br/>The reason for the poor performance is not attributable to SYICB but a result of combined demand and capacity pressures at STH. <br/><br/>Regulation 14(2)(c): Delaying the award of the contract to satisfy the requirements of the other relevant PSR regulations would likely pose a risk to patient or public safety<br/>There is an immediate risk to patient safety due to delays in cancer diagnosis. The FDS is described by NHS England as being essential to ensure patients who are diagnosed with cancer can begin their treatment as soon as possible, and put those who are not diagnosed with cancer at ease sooner (see https://www.england.nhs.uk/cancer/faster-diagnosis/). The aim of this emergency tele-dermatology provision is to reduce the number of referrals on the USC skin pathway at STH (slowing demand) by ensuring only those genuine USCs are referred on the USC pathway and start their treatment as soon as possible.<br/><br/>The contract has been awarded for 6 months from 5th December 2024 with an option to extend on a rolling monthly basis for an additional 6 months (total contract term maximum of 12 months). <br/><br/>Rolling extension will be used where:<br/>a) provision identifies a reduction in demand on the USC skin pathway in Sheffield by improving the quality of images sent with referrals; <br/>b) this reduction in demand is contributing to the skin Faster Diagnosis Standard (FDS) recovery at Sheffield Teaching Hospitals NHS Foundation Trust (STH); and<br/>c) if a provision is deemed as required in Sheffield post the initial 6 months, to allow time for any discussions with primary care on the longer term approach to image capture and any resulting decisions to be undertaken in accordance with the relevant legislation and mobilised. <br/><br/>The lifetime value of the contract will be £110,861.50 (total over the maximum available 12 month term).This is new service with a new provider.