NHS England South East Specialised Commissioning Provision of NHS Complex Termination Of Pregnancy Services for patients with medical complexity and/or significant co-morbidities - Regional Network Lead Provider

Lots (1)

1. 01

   Lot 1Planned

   This notice is placed to set out NHS England South East's (the Commissioner's) intention to follow the Most Suitable Provider Process. NHS England South East is seeking a suitable provider who has the capability and capacity to deliver Complex Termination Of Pregnancy Services for patients with medical complexity and/or significant co-morbidities, in line with the specified requirements, in the capacity of a Regional CTOP Lead Centre.

   The aims of the service are to:-

   • Ensure that people needing NHS care for safe termination are always able to access specialised termination services up to 23 weeks 6 days of gestation (regardless of the legal ground)
   • Provide rapid access to local, safe, effective and satisfactory terminations for individuals excluded from treatment in routine termination services due to the complications posed to safe termination as a result of the patient's medical needs or significant co-morbidities
   • Ensure that people with significant co-morbidities have access to NHS Centres at early gestation and in line with national gestation group (weeks) profiles where safe care requires NHS input
   • Maximise safety by providing local access to high quality expertise in specialised termination services up to 23 weeks 6 days of gestation with access to multidisciplinary teams and acute peri-abortion care when needed
   • Ensure that the quality of the care provided is nationally monitored and subject to a process of continued improvement (though a national dashboard)
   • Participate in national data collection to improve understanding of service needs across the country to allow optimisation of outcomes and resources - improve understanding of optimal methods of treatment through analysis and publication of data - standardise the assessment criteria across all ISP specialist placement teams
   • Increase access to training opportunities in surgical terminations after 14 weeks of gestation, leading to a more robust workforce in termination services across sectors as well as an expansion of services at a greater range of gestational ages within NHS hospitals The Regional Network Lead Provider (hub) will work collaboratively with the Regional Network Providers (spokes). The Regional Network Lead Provider role will:
   • host the single point of access (SPOA) for all CTOP referrals
   • lead the multi-disciplinary team (MDT)
   • lead the training, upskilling and maintenance of skills programmes for the region (Nationally mandated in order to access specific additional training funding allocation)
   • provide CTOP care for both surgical and medical treatment methods up to 23+6 weeks gestation Funding for the CTOP Service(values based on 24/25 price base) The CTOP service will be funded in addition to the existing TOP tariff provided to providers by Integrated Care Boards (ICBs). This additional funding, totalling PS408,000, will be sourced from the SRB reserve, as directed by the National Specialised Commissioning Senior Programme of Care Manager for Women's and Children's. While this funding is recurrent, it is based on assumed activity levels and not directly tied to actual activity. Funding Breakdown The total annual funding for the CTOP service is allocated as follows:
   • Recurrent training support: PS122,000 - Hub
   • Non-Recurrent Network Funding: PS62,000, per year for 3 years - Hub
   • Activity-related costs: PS224,000 - Hub and Spokes Training Funding Details This recurrent funding is aimed at ensuring the sustainability and quality of the CTOP service through:
   • Workforce training and upskilling: Supporting local providers to offer surgical terminations up to 23+6 weeks gestation within the South East (SE) region.
   • Ongoing development: Providing continuous training to sustain high standards of patient care.

   Release of recurrent funding is contingent on NHSE SE submitting a detailed spending plan to the NHSE National team. Network Funding Details The non-recurrent allocation of PS62,000 is designated for establishing critical service components, including the SPOA, MDTs, and M&M meetings, within the Hub provider. How the network funding is to be utilised may change after the end of year 3.

   Activity Assumptions and Reconciliation Activity assumptions for the CTOP service are based on data from existing TOP services. A block allocation of top-up funding will be provided initially. Once data collection begins through the SPOA, periodic reconciliation will occur to compare funding against actual activity levels.

   Training Implementation A structured training program will be implemented to upskill local providers, enabling them to deliver surgical termination services within the SE region. The Hub provider will outline the timeline for this training once the service is formally commissioned. The Contracts will be for a term of 5 years with an optional extension period of 2 years.

   Services are planned to commence from 1st April 2025. Services will be contracted using the latest version of the NHS Standard Contract. Under rule 5a of the NHS Payment Scheme 2023-25 (amended) March 2024, this contract is exempt from Aligned Payment Incentives (API).

   This exercise is being carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioner.