II.2.3) Place of performance

NUTS code:

UKK41

Main site or place of performance:

It is a requirement that this service must be based in the Plymouth locality. The beds will be for the short-term placement of patients discharged at end of life from University Hospital Plymouth and registered with a Plymouth GP

II.2.4) Description of the procurement

NHS Devon ICB is seeking to procure provision of 4 block booked beds in appropriate hospice accommodation, to support discharge from hospital for patients at end of life from University Hospital Plymouth who are unable, or do not wish, to return to their home address.

It intends to complete this procurement via a Most Suitable Provider Process under the Provider Selection Regime.

It is essential that the pathway supports the timely discharge of people at end of life, particularly for those people rapidly deteriorating for whom there is a limited window for a safe and appropriate discharge from hospital to be achieved.

The provider will be responsible for all medical support and care needs for individuals in these block beds and will be expected to provide Consultant oversight.

The contract will be in place to support during forthcoming winter pressures in the Plymouth locality.

The contract will start immediately on completion of the procurement and will run for 12 months initially, although will include a 6 month break clause. 2 x 6 month extension options will be included should the capacity continue to be required after 12 months.

This service is commissioned on a block contract purchase basis for end of life nursing beds with the following guaranteed activity levels:

4 End of Life Nursing Beds

The current weekly rate for occupied beds is £1,118.38 with a 50% rate pro rata for vacant beds.

II.2.14) Additional information

1. Provider will need to support people being discharged from UHP who are registered with a Plymouth GP.

2. Provider will need to be able to provide 4 hospice beds within the Plymouth area.

3. Provider will need to be able to prescribe and administer medication.

4. The provider will be responsible for all medical support and care needs and will be expected to provide Consultant oversight.

5. Provider will accept the CHC banded fee rate, as above, which is inclusive of all accommodation and care provision as prescribed within the person's Care Plan

6. Provider will need a CQC Rating of 'Good' or above

Additional information about the service specification requirements:

1. A documented care plan that meets the person's assessed needs and comfort will be drawn up and agreed with them, their relatives and relevant professionals. The care plan should follow the recommendation for palliative and end of life care as detailed in current guidance.

2. Staff within the hospice, and other members of the multidisciplinary and specialist palliative care teams work together as appropriate to plan the care. The person (if appropriate) and their relatives are involved in the decision making process, care planning and delivery and are kept up to date with developments.

3. The outcomes of symptom control and end of life care are monitored and are subject to review and reassessment at agreed time intervals with the person and their relatives being involved in the review and reassessment together with the relevant healthcare professionals.

4. The person is assessed regularly, including their hydration and nutrition needs, and interventions to promote comfort and dignity are initiated in a timely and response manner.

5. Pain management medications are prescribed and when administered, their effect monitored to ensure that they provide relief, and that the person is comfortable. This may include anticipatory prescribing to ensure that medication is available in a timely fashion.

6. Pain relief medication is prescribed in line with current best practice guidelines and staff are aware of these.

7. Staff will ensure that the cultural, religious and spiritual needs of the person and their relatives are identified and met in a sensitive manner through connections with members of the local faith community.

8. When the person is believed to be imminently dying, their family and friends are facilitated as far as possible and in accordance with the person's wishes to spend as much time with them as they wish. This includes overnight stays if feasible.

9. There is a room or private space available where relatives are able to talk privately.

10. In the event that relatives are unable to be present, the provider will make arrangements to ensure someone is deployed to sit with the individual so that they are not left alone while dying.

Any providers meeting the basic qualifying criteria will be evaluated against the 5 key criteria set out in the Provider Selection Regime: Quality, Value, Integration, Equalities and Social Value.

Given the nature of the need, in this instance a high weighting will be allocated to local integration.