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.