Microbiology Services

The Royal Marsden is currently exploring alternative operating models for its microbiology services and is undertaking a market engagement exercise to gather insights from providers. The exercise is designed to be a fact-finding and there is no formal evaluation. Providers are encouraged to propose individual solutions on their approach to service delivery and guidance on how to structure responses is listed in the attached .

The objective of the market engagement exercise is to inform decision making on whether to move forward with a formal tender, but this is not a guarantee at this stage. With details of contract start dates provided only as estimates in the event there is a decision to progress to tender. Service Overview Effective microbiology services are essential for the timely diagnosis of infections.

For the oncology patient population microbiology screening, advice and guidance on treatment options and oversight of anti-microbial stewardship are also vital in ensuring individual treatments are optimised. Environmental testing provision is also in place to support cellular therapy, radiopharmacy and aseptic services. At the Royal Marsden Hospital the microbiology service consists of two discrete but collaborative functions.

A UKAS accredited microbiology laboratory and a clinical microbiology service. The microbiology laboratory is based at our Sutton site, providing microbiology testing for our Chelsea, Sutton and Cavendish Square sites. The laboratory processes approximately 187, 000 samples per year.

With approximately 65% of these tests requiring a turn-around time of 24-48 hours for a positive result. for detailed breakdown. Clinical microbiology provides a core advice and guidance function in addition to reporting of microbiology testing, oversight of the laboratory and contribution to antimicrobial stewardship ward rounds and specialty meetings. The function provides clinical leadership for the Trust's infection prevention and control service, teaching and leadership on departmental research projects as required.

For a full breakdown of key activities please refer to the second tab of the attached spreadsheet titled Out of hours clinically urgent testing or clinical advice and guidance is provided on agreement with the on-call clinical microbiologist, with the laboratory on-call biomedical scientist providing urgent testing as required. For a full breakdown of expected activities for the "Out of Hours" function please refer to the third tab of the attached spreadsheet titled The aim for the Royal Marsden Hospital is to ensure a cohesive, sustainable and cost-effective microbiology service that meets the clinical needs of our cancer patients. To that end the Trust has decided to gather information on all possible options for future service delivery and is opening up an early market engagement to explore potential provision options for one, a combination of or all of the below services:

• In-hours core clinical microbiology services
• Out-of-hours urgent clinical microbiology services
• Microbiology laboratory testing services The Trust is seeking to understand from both NHS and private sector providers proposed approaches to delivering one or all of the above listed services. Respondents are encouraged to provide individual solutions to delivering the above-described services. Paying consideration to their approach to the following criteria: Service Delivery
• Meeting turnaround times for urgent and standard testing, result authorisation and advice and guidance
• Sample transport and tracking
• Maintaining continued UKAS accreditation
• Resourcing and skills mix of staff to maintain day to day service resilience and long-term sustainability of the service
• Digital inter-operability and compliance to NHS and U.K. information governance and cyber security regulations Business Continuity
• Long-term workforce strategy incorporating recruitment, staff development and retention
• Robust business continuity plan to address activity surges, staff shortages, digital outages or other major incidents Clinical Alignment
• Adherence to RMH testing protocols and anti-microbial and infection control policies
• Adherence to JACIE transplant Standard Operating Procedures and Human Tissue Authority licensing standards
• Alignment with the Trust's clinical governance framework
• Aligning clinical decision making to RMH requirements and approaches to maintaining adherence across services i.e. Laboratory and Clinical Microbiology
• Communication and liaison with key clinical and operational stakeholders
• Training and development of staff
• Ensuring up to date best practice and implementation of innovative technologies and process efficiencies Financial Reimbursement
• Expected financial reimbursement model e.g. reimbursement per test and staff cost estimates (laboratory and Clinical microbiology). Directions for Respondents As this is a market engagement exercise no formal information framework is included. To structure responses the Trust would appreciate feedback as per the format outlined in the within the attached documents. All questions are optional any feedback received will not be evaluated and will be used for information purposes only. Please note that completion of the information within the pack will in no way obligate your organisation to participate in any future related tenders. Nor will it have any impact on the outcome of any future related tenders. Conversely failing to participate in the process would in no way preclude your organisation from participation in any future related tenders. The purpose of the questionnaire is to gain a greater understanding of the market, particularly the potential for any new developments in the sector. With full confidentiality maintained throughout the exercise. Microbiology Laboratory (Core hours and out of hours service) Provision of a microbiology laboratory ISO15189. For the list of tests please refer to Tab 1 in the attached document titled . Provision of environmental testing required for the production of cellular therapy, aseptic and radiopharmaceutical products under ISO17025. Opening Hours: Core Hours 08:00 - 18:00 Monday to Friday Out of hours testing Outside above stated hours for 24 hours a day (inclusive of weekends and bank holidays) Testing During core hours, to provide microbiology, viral serology testing services for the tests included in the linked document, within the stated turnaround times (TaTs). (Expected TaTs are listed in Tab 1 of the attached document .) Out of hours, ensure provision to liaise with on-call clinical microbiologist. Undertaking testing when deemed clinically urgent. Transit To accommodate sample referrals from the Royal Marsden's Sutton, Chelsea and Cavendish Square sites. With sample collections sufficiently frequent to meet required turnaround times with adherence to UN133 sample packing and storage requirements. Communication and prioritisation During core hours to provide direct telephone liaison between Royal Marsden clinical staff and the laboratory. To ensure provision is in place for urgent samples to be prioritised for processing, as and when agreed with the clinical microbiologist. Clinical Microbiology (Core Service) To enable sufficient clinical microbiology provision to deliver the following services from 09:00 - 17:00 Monday to Friday:
• Advice and guidance (Urgent and General)
• Result reporting and verification
• Attendance at daily MDTs
• Clinical leadership of RMH's anti-Microbial stewardship
• Clinical contribution to RMH's Infection Prevention and Control agenda For further details please refer to the Clinical Microbiology Schedule of Activities in Tab 2 of the attached document . Clinical Microbiology Service (Out of hours Service) Monday to Friday (17:00 to 9:00) and for 24 hours during weekends to provide sufficient clinical microbiology provision to cover the following:
• Reactive advice and guidance (Telephone, email and digital messaging)
• Result reporting and verification For more details please see Tab 3 of the attached document .

Please note that all additional supporting documents are located under Atamis Project Ref: C404289