Agenda item

Consideration was given to a report of the Managing Director, Community Health and Adult Social Care which sought approval to extend the current contract for Oldham’s Health Checks which expires on 31/03/2022.

This report requested an extension until 30/06/2022 to cover procurement timelines and outlined a proposal for the new service specification which would form the basis of the new five year Health Check contract.

It was reported the Oldham Health Check was Oldham’s approach to delivering the nationally mandated NHS Health Check service which Oldham Council commissions from the Public Health budget. Health Checks involved residents being asked a series of health and lifestyle related questions and a series of tests being performed. The aim is to identify those who are at a higher risk of developing heart problems so that preventative action can be taken.

Residents aged 40-74 who haven’t already been diagnosed with certain conditions are eligible for a Health Check every 5 years; the national target is for 75% of eligible residents to receive their Check every 5 years.

Most GP practices in Oldham provide Health Checks, as well as three pharmacies. The current budget for Health Checks in Oldham is £138,000 per year. This budget is enough to provide checks for 45% of the eligible population every five years based on the current price commissioned per Health Check.

It was proposed that £1,500 of the £138,000 budget was retained for training and communications to promote Health Checks, the remaining £136,500 would be retained for delivery. Oldham Council also pays £32k/year to EMIS to access the system; shared EMIS access with the CCG is being explored which could mean that £32k/year is saved.

Various engagement has taken place to inform the new service specification. This engagement, as well as our priorities as a borough and our knowledge of how Health Checks have worked in the past, has informed the five priorities for the Health Check programme going forward:

1)         Reducing health inequalities

2)         Targeting residents at highest risk of cardiac events

3)         Commissioning for improved outcomes

4)         Focus on Mental Health within the Health Check

5)         Focus on Diabetes within the Health Check

Aligning with these priorities, colleagues were asked to consider the key changes to the Oldham Health Check contract outlined in detail in this report, and summarised below:

• Prioritising patients based on their risk – this report outlines an approach whereby patients will be prioritised for their Health Check based on their existing cardiovascular risk score and/or lifestyle factors such as smoking and BMI. Evidence suggests this improves the effectiveness and cost effectiveness of the Health Check Programme. Military veterans and asylum seekers aged 18 and above will also be prioritised for the Health Check given they are more likely to experience health inequalities.
• Model of Delivery – while many GP practices will want to deliver the Oldham Health Check individually, the contract will give practices the option to apply as a consortium of practices or as a PCN. Payments will be made quarterly in advance (except for quarter 4, see below) to allow providers dedicated resources to deliver the Health Check programme.
• Commissioner rather than provider led volumesand prioritising funding for our more deprivedareas – currently the number of Health Checks delivered is determined by how many providers want to provide. The new specification will include target volumes for provider, with our most deprived areas having higher targets to help reduce health inequalities in these areas. This arrangement will mean providers in our more deprived areas receiving the biggest share of the annual Health Check budget.
• Incentivising quality – the current contract provides no incentives to provide a quality Check and quality follow up (e.g. referral to Your Health Oldham). The new contract will hold back the fourth quarter payment to providers and only pay this if a number of targets linked to quality are met.
• Questions about patient’s Mental Health – given the importance of mental health in the borough, particularly since Covid-19, four questions are to be added to the Health Check which ask about a patient’s mental health. Provider staff will receive training to support this and a pathway for onward support is in development.
• Onward referrals and integrating Your Health Oldham – there were no accurate Oldham data on the number of onward referrals for lifestyle support after a Health Check, but based on experience from other regions, this number is expected to be low. The new specification will emphasise the importance of onward referral and provider training will include a shift in language towards a default to refer to onward support where certain conditions are met.
• Improving our data and reporting –The service specification would outline a range of metrics which will be collected to help drive improvements in outcomes from Health Checks.

Options/alternatives considered

Option 1 - Agree to extend the existing the current Health Check contract which is due to expire on 31/03/2022 for a period of 3 months to 30/06/2022 to allow time for the procurement process to be complete.

Approve the request to proceed to market for the procurement of the Oldham Health Check for a contract length of 3 years + 2; 5 years in total for a value of £682,500 (£136,500 per year for 5 years).
Delegate authority to the Director of Public Health, in consultation with the Cabinet Member for Health and Social Care, to approve the recommendation of the evaluation panel, in accordance with the results of the procurement exercise (based on quality, social value and financial modelling), on behalf of Oldham Council.

Agree on the suggestions outlined in this paper for changes to the new Oldham Health Check contract in Oldham from 2022.

Option 2 - Continue to procure Health Checks by replicating the existing contract.

RESOLVED – That:

1.    The existing Health Check contract which is due to expire on 31/03/2022 be extended for a period of 3 months to 30/06/2022 to allow time for the procurement process to be complete.

2.    The request to proceed to market for the procurement of the Oldham Health Check for a contract length of 3 years + 2 years; 5 years in total for a value of £682,500 (£136,500 per year for 5 years) be approved

3.    Delegated authority be given to the Director of Public Health, in consultation with the Cabinet Member for Health and Social Care, to approve the recommendation of the evaluation panel in awarding the provider contracts, on behalf of Oldham Council.