Decision details

In April 2013 the NHS Health Check became a mandated public health service in England. Local authorities are responsible for making provision to offer an NHS Health Check to eligible individuals.

Since 2012 the programme in Sheffield has been delivered solely by and within GP practices according to former Local Enhanced Service agreements between Public Health and individual GP practices that novated to the Council in 2013 and has subsequently been extended until 31st March 2017. Sheffield City Council is now seeking to commission a single, or multiple service providers to deliver the NHS Health Check programme for Sheffield.

Evidence suggests that the NHS health check programme would be more effective if resources are targeted towards those at highest risk of developing cardiovascular disease. A targeted approach would also mitigate against widening health inequalities in Sheffield.

Approval from the executive team is requested to be able to re-commission this service and  for a proportionate universalism approach to be used where there will be the availability of a universal service for all eligible residents, with most resource target at those with higher risk factors.

(i) That approval is given to carry out a procurement exercise for the Health Check Service for the period of 2 years, with an optional one year extension period;

(ii) that authority be delegated to the Director of Public Health in consultation with the Interim Director of Financeand Commercial Services to develop and approve the procurement strategy for the tender for Health Checks for eligible individuals;

(iii) that authority be delegated to the Interim Director of Finance and Commercial Services to agree Contract terms and approve a contract award following the tender process;

(iv) that approval is given to the annual spending of approximately £185k for the 1st year of the contract 2017/18 and for the 2nd year, subject to further reduction in line with this report, in the region of £148k; and

(v) delegate to the Director of Public Health in consultation with the Interim Director of Finance and Commercial Services to take such other steps as he may deem appropriate to achieve the proposed changes to the service specification to target resources to those at higher risk of developing CVD.

The preferred option to commission a single, or multiple service provider(s) to deliver the NHS Health Check programme either for the whole city or for a particular locality for local people that may itself sub-contract with another provider(s) opens the tender up to a market including voluntary, community and faith sector and leisure and fitness sector providers who may be able to reach those that are not currently taking up the opportunity of the NHS Health Check.

The intended outcomes will be that this option will secure a universal offer for those at lower risk of CVD and target most resource at those from priority groups, thus contributing to a reduction in health inequalities. It will ensure that the programme remains within budget.

Do nothing option – Continue to procure solely from GPs. This contract transferred as a Locally Enhanced Service (LES) from the Primary Care Trust in 2013 to the Local Authority. As this contract has already been extended under a sole tender waiver, it must now be offered to open competitive tender.

Any qualified provider on a tariff based system – any provider that was qualified i.e. could meet information and clinical governance standards, would be placed on a framework of providers. Patients could receive their health check from any of the qualified providers. Providers would be paid a set rate “tariff” per patient. No minimum activity would be guaranteed but a cap would be placed on overall activity to ensure no financial risk to SCC.

A small retainer would be made to providers to retain their services and ensure initial operating costs would be covered. Bonus payments would be made subject to the city as a whole achieving take up rates from priority groups. This bonus would be paid pro-rata according to the contribution made to the target from the providers. This option was rejected because of the staff capacity in terms of being able to quality audit a wide range of providers and further, because of the need to determine eligibility and target those at highest risk – this would require information sharing with a number of providers and therefore presents a risk to information governance.