Decision details

Due to the global Public Health emergency COVID-19 pandemic approval is sought to immediately implement a Co-Operation agreement variation to strengthen, enhance and increase capacity and capability of the existing Infection Prevention and Control Service under the Modification of Contracts during their term under Regulation 72 (1) (C) of the Public Contracts Regulations 2015. This service is commissioned by Public Health to Leeds Community Healthcare NHS Trust (LCH) and is required to scale up in order to implement and deliver on outbreak management the new COVID-19 NHS Test and Trace programme announced by the Government on the 27^th May 2020.

The Government has provided £300m to Local Authorities in England for the Test and Trace programme, Leeds has received a £4,141,249 non-recurrent ring-fenced grant. To increase the capacity of the existing Leeds Infection Control and Prevention service at a cost of approximately £529,200 annually for a period of 2 years with the option to extend by 12 months, the rationale for this time period is due to the COVID-19 pandemic and the need to have a robust contract with flexibility with the Provider. This will be achieved by formally entering into a co-operation agreement variation with Leeds Community Healthcare NHS Trust to deliver this new vitally important service immediately as the start date announced by the Government was 28^th May 2020. This will be reviewed annually.

The existing Infection Prevention and Control Service has the specialist skills, knowledge and expertise to deliver this programme.As requested, please see a case for resource to support local outbreak plans in Leeds.

Leeds has strong local health protection outbreak management arrangements in place which has ensured that we have been able to immediately scale up, on a temporary basis, to respond to COVID-19 in Leeds, working on the principle of building on existing arrangements. The LCH infection prevention service is an integral service in the provision of the local outbreak management response to community settings in Leeds. Whilst the service has responded effectively to this initial surge in demand through temporarily increasing capacity through mutual aid, this urgently needs reviewing to ensure we have a resilient, effective and responsive service that can manage the increased demands on a more sustainable footing. The next phase of responding to the pandemic will include implementing the Test and Trace programme and managing local COVID 19 outbreaks across the city. In order to do this we need to rapidly increase the existing capacity of the LCH infection control service, as directed by the national COVID -19 Test and Trace programme in Leeds.

Additional resource is required to:

• Increase capacity and capability of existing LCH Infection Prevention Service to ensure there is sufficient capacity to implement the national Track and Trace programme and safely manage outbreaks in Leeds. Additional resource would enable the service to scale up to deliver the following areas as outlined in the ‘test, track and trace local delivery model’:

·  Local outbreak management in complex settings (care homes/ schools / hostels)

·  Direct infection prevention and wider support to complex groups and households

·  Proactive advice & guidance (e.g. schools/ workplaces)

·  Local engagement & intelligence gathering (e.g. VCS/ LA front-line)

·  Local communications

·  Care home testing/ support and contact tracing.

Specific activities required from LCH IPC service will include:

Increased provision of Infection Prevention and Control (IPC) training (increased frequency and additional training requirements including PPE, COVID specific topics, new updated evidence) to care homes using innovative ways of ensuring delivery. Monitor and report monthly on numbers training and evaluations.

Increased provision of IPC training to homecare and other community settings such as luncheon clubs using innovative ways of ensuring delivery. Monitor and report monthly on numbers training and evaluations.

Develop and deliver an IPC package for schools and early year’s settings and engaging with existing work across the city. Monitor and report monthly on numbers training and evaluations.

Provide IPC expertise to the management of covid-19 outbreaks, incidents and cases of concern.

Monitor the number of outbreaks providing daily contact to schools, nurseries and care settings and a daily update across the system.

Manage and respond to IPC enquiries relating to Covid-19.

Promote best practice based on evidence across the Leeds Health and social care system.

Provide a 7 day service, Mon – Fri 8am-5pm, Sat, and Sun 9-5.

Ensure the ability to set up IPC services to manage a surge in Covid-19 cases

Retain the ability to test for Covid-19 should it be required.

This is the best value for money option as the skills and local knowledge already existing in this team.  The NHS test and trace programme is a local level programme which will support the residents of Leeds and provide an essential element against the fight against COVID-19 and saving lives.

This request to increase capacity has come as a recommendation from the National Test and Trace programme and from discussions at a Leeds Gold command level, supported by the Association of Directors of Public Health. It is working on the principle of enhancing and boosting existing outbreak management systems and services as agreed regionally. LCH Infection Prevention Service is the only Infection Prevention Service provider for the community in Leeds and has a strong and award winning track record of effective outbreak management in the community, there is no other service operating in Leeds that could provide this service. This service operates in a fragmented and complex health protection system with well-established systems, relationships, local networks and intelligence and is well placed to provide an enhanced service to implement Test and Trace and meet the future demands of responding to the management of COVID-19.

Extending or modifying a contract during its term

The modification of contracts is governed under the Public Contracts Regulations 2015 at regulation 72 which permits certain types of modifications. It considers the extent to which a contract may be modified before it should be considered so substantially changed as to necessitate a new procurement. Permissible grounds for modification include a need for additional services due to unforeseen circumstances (subject to 50% maximum increase in initial contract value).  It also requires the consideration of the effect of cumulative variations. Therefore this needs to be considered in taking this decision.

The provisions of Regulation 72 (1) (C) provide an exception to a new procurement “where all of the following conditions are fulfilled:—

(i) the need for modification has been brought about by circumstances which a diligent contracting authority could not have foreseen;

(ii) the modification does not alter the overall nature of the contract; and

(iii) any increase in price does not exceed 50% of the value of the original contract or framework agreement.”

In relying on this regulation to modify the contract, the Council will be required to send a modification notice to that effect for publication at EU level, in accordance with regulation 51.

Due to the council formally entering into a co-operation agreement with another Public Body namely LCH, the Infection Protection and Control service agreement will continue on a rolling basis with the option to end the agreement by ether party. Since the agreement is a partnership arrangement it is deemed extremely unlikely that the partners will invoke the option and the agreement will continue for countless years to come with the standard performance review procedures being applied by both parties. 

The Director of Public Health noted that the Government has provided £300m to Local Authorities in England for the Test and Trace programme, Leeds has received a £4,141,249 non-recurrent ring-fenced grant. To increase the capacity of the existing Leeds Infection Control and Prevention service at a cost of approximately £529,200 annually for a period of 2 years with the option to extend by 12 months, the rationale for this time period is due to the COVID-19 pandemic and the need to have a robust contract with flexibility with the Provider. This will be achieved by formally entering into a co-operation agreement variation with Leeds Community Healthcare NHS Trust to deliver this new vitally important service immediately as the start date announced by the Government was 28^th May 2020. This will be reviewed annually.

Through skype meetings.

Cllr Charlwood and Cllr Hayden.