Agenda item

Report from the Cabinet Member for Health and Wellbeing

Councillor Tamoor Tariq,  Cabinet Member for Health and Wellbeing presented the report which set out a plan to extend Bury Council’s substance misuse contract with GMMH for a further six months.

DECISION

Cabinet:

• Agreed to extend Bury Council’s substance misuse contract with GMMH for a further six months, from 1 st September 2024 – 31st March 2025 to align to the end of the 2045/25 financial year.
• Agreed a one of £70,000 payment to uplift the substance misuse contract from 1 st September 2024 – 31st March 2025. Which will be funded through Office Page 370 for Health Improvement and Disparities (OHID) Supplementary Substance Misuse Treatment Grant (SSMTRG) underspend (at no extra cost to the council).
• To make a direct award to the current provider, GMMH, for a period of three years, with the option for the Council to extend for an additional two years at its discretion – starting on April 1st 2025.
• Agreed the new total estimated cost for the three years commencing 1st April 2025 at £1,560,000 per annum, with the same amount allocated per annum thereafter, (subject to inflation and Agenda for Change pay increases). This will be funded through Public Health budget (including a small amount of substance misuse reserves) and there are no requests for additional funding.
• Agreed to delegate the negotiation and finalisation of contracts to the Director of Public Health in consultation with the Director of Law and Governance.

Reasons for recommendation(s):

Current Performance

• The Council is happy with the current performance of GMMH. Its substance misuse services were rated as outstanding from their most recent inspection by the Care Quality Commission (CQC) in 2018.
• In 2022 GMMH had an independent, external provider evaluate the partnership model, which overall was considered to work very effectively and reflect the aims of the contract.
• This option would allow the Council to continue to build on already existing, positive relationships that have been built over the last four years, not just between GMHH and Bury Council but between it and numerous other external partners. Continuing with the current provider will enable current projects and funding streams to continue seamlessly. The current contract represents good value for money, compared to other organisations and localities, evidenced in supporting documents.

Proposed Procurement Route

• A competitive tender process would put extensive pressure on existing resources and staff time and would likely require additional support. In addition, stability and continuity of well performing providers is mentioned frequently as being essential to the care and wellbeing of service users and organisational staff, which is reflected in the potential future implementation of The NHS Provider Selector Regime (PSR). The PSR will aim to introduce increased flexibility and transparency to the procurement of healthcare services and will aim to support greater integration and the establishment of stable collaborations. The continuation of the current provider is in the best interest of the service users, all staff involved, taxpayers and the local population.
• It is proposed that the Council continues with its current contract provider GMMH once the current contract comes to an end. Legal Services have advised that it is in order to make a direct award to GMMH in reliance on the Hamburg case exception, now codified as Regulation 12(7) of the Public Contracts Regulations 2015. That Regulation permits a direct contract to be awarded between the Council and an NHS or other public sector body, without Page 372 competition. It is subject to ensuring the contract is in the public interest and that the public services they each have to perform are provided to achieve common objectives.

Budget Provision

• Annual budget provision is available from Public Health funding (£1,367,360), with £192,640 of funding available from Children’s which contributes to the Children’s & Young People’s element of the contract via Early Break

Alternative options considered and rejected:

Tender for new provider(s)

Pros:

• Allows direct comparison to other providers.
• Offers confirmation that the Council is getting best value for money.
• Can ask for more for the same value, whether this takes the form of price reductions, better service, higher quality products or other added value.

Cons:

• Disruption to current service users and staff. Anecdotal reports from the last tender in 2018 demonstrated that implementation of a new provider caused significant disruption to service users and triggered low staff morale.
• Potential disruption to performance.
• Leaving the commissioning arrangement with GMMH could result in the loss of collaborative expertise, workforce, reduced best practice sharing and diminished support for individuals.
• Based on an understanding of the current market, there is unlikely to be a better provider for this role and we believe it is good value for money.
• Loss of the positive, collaborative relationships already built.
• Would interfere with current / planned projects and external funding streams (OHID grants).
• A tender process would require extensive use of resources (particularly staff time across the organisation), which would come at a significant opportunity cost, preventing time being spent on primary prevention and current workstreams. This process would be complex and would need to consider adults, young people, and assertive outreach. This may involve tendering for more than one provider. Likely to require additional capacity to support the process.
• May lose partnership between neighbouring authorities (Bolton, Salford and Trafford) who also have GMMH as their substance misuse provider. This currently allows for economies of scale of work, shared back-office functions and a peer support approach across all organisations involved.
• Potential loss of the benefits of the partnership model that is in place with GMMH as lead provider. The current partnership model incorporates both NHS and third sector organisations, meaning the Council is able to benefit from both types of organisations working on our substance misuse agenda.
• If we go to retender, the council will need to procure under the new procurement Act (2023) under the new Provider Selection Regime (PSR) which is to be implemented from February 2025. This new act will change process to procure health services and adhere to new processes and legislation.