​We rapidly responded to a crisis with the Tier 4 Bariatric Service by providing support services across the north region ensuring the vital continuation of patient access  

Background

The Tier 4 collaboratively commissioned Bariatric Service contract for the North Region was due to cease in March 2019. NHS Midlands and Lancashire (NHS ML) services developed a paper proposing a way to secure a long-term provider of services for the Lancashire, South Cumbria, North Cumbria and Cheshire and Merseyside areas. During the engagement process with commissioners the incumbent Tier 4 Bariatric Service provider escalated a crisis point whereby a service notice of suspension was served on all referrals from these areas. ​

Action

We provided support services across the North Region:​

• High quality programme management and commissioning expertise and leadership to ‘caretake’ the collaborative commissioning situation​
• Specialist expertise in programme management, contract management, procurement and business intelligence, supporting NHSE/commissioner assurance on patient RTT pathway and 52-week breach positions​
• A robust patient transfer solution from incumbent provider to interim utilising a high-quality referral management centre (RMC)​
• Identification, engagement, due diligence activities and negotiation with potential interim providers in both the public and private sector​
• Preparation of activities to run a robust procurement for Tier 4 and explore an innovative procurement process for interfacing Tier 3 provision.​

Impact

The impact of NHS ML’s team in the commissioning of collaborative Tier 4 Bariatric services was:​

• The establishment of interim providers in response to a crisis with a commissioned incumbent provider, meaning that patients could continue their pathway and mitigating the impact of long patient waits (200+ patients received their surgery)​
• The commissioning of a range of high quality, best value interim providers to manage referrals from the North Region (LSC/C&M)- delivering services closer to home for our population​
• System pathway mapping and provider market engagement delivering enhanced commissioner understanding of currently commissioned weight management pathways and services​
• Effective provider management of 52 week wait to ensure patient pathway progression and provide regulatory assurance and commissioner assurance on delivery​
• Demonstration of the capability of NHS ML to act in the role of strategic partner within the Lancashire and South Cumbria Integrated Care System.​

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