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Innovative procurement of pain management services

We worked with West Lancashire Clinical Commissioning Group on an innovative procurement of a community-based, holistic pain management service where a previous process had failed.

Background
West Lancashire had no specialist community-based chronic pain service; patients were being managed between GPs and hospitals. An attempt to procure a service using a traditional OJEU (Official Journal of the European Union) approach and fixed specification had failed even though the marketplace showed interest.

West Lancashire Clinical Commissioning Group (WLCCG) worked with our Procurement Team to procure a service that would:

  • meet patients’ holistic needs through a personalised care plan, using new technology to enable self-management and non-medical interventions
  • end unnecessary referrals to secondary care
  • reduce prescription of pain medication.

Action
We worked with WLCCG to develop an OJEU Innovation Partnership procurement under the Light Touch Regime. We defined the problem and gave bidders freedom to create a solution. Bidders were able to collaborate with commissioners throughout the process so they could fully understand patient needs and produce a tailored solution.

Our approach included:

  • Soft market testing event
    • Stimulated interest
    • Enabled potential bidders to meet Voluntary, Community, Faith and Social Enterprise (VCF&SE) organisations who could help them design their solution
  • Workshop sessions
    • Bidders and VCF&SE organisations contributed to the vision of iHELP and helped shape the procurement process
  • Design phase
    • Bidders had regular access to the project team, CCG specialists, local GPs, patient engagement groups and third sector providers to help shape their solution
  • Two-year pilot phase tender
    • Included focus on increasing social value
  • Negotiation workshops
    • Helped shape a solution that was affordable, able to deliver savings in line with the WLCCG’s aims, and able to furnish the provider with adequate return.


Impact
The Innovation Partnership was such a strong enabler for WLCCG to be bold in seeking creative solutions that it has since commenced another procurement using it (the first NHS commissioner to attempt a second).

iHELP (Integrated, Holistic, Empowering, Learning Programme), the new service resulting from the procurement process, offers specialist care with a holistic approach to meet patients’ pain management needs. The innovative solution:

  • facilitates safe and speedy access to relevant information
  • improves care, outcomes and experience
  • streamlines the use of resources
  • realises cost savings.

The successful provider, Inhealth Pain Management Solutions, exceeded expectations with their solution. The pilot contract commences 1 April 2019 for two years, with provision for a further five years following review.

RightCare indicators suggest WLCCG could save on chronic pain spend whilst also improving care and the health of current and future patients. Around £600,000 of net savings are predicted for a full year.

“We are proud to have worked innovatively with bidders to develop a clinically led solution which improves patient care significantly whilst also reducing unit costs. The savings generated will be available to further enhance patient care in the area.”
Jenn Greenhalgh, Senior Finance Manager, West Lancashire Clinical Commissioning Group

“The development of the West Lancashire iHELP service represents a real step forward and innovation in the way commissioners worked with the local Voluntary, Community, Faith and Social Enterprise sectors (VCF&SE) to co-produce new approaches to partnership working and health services. From the first idea the VCF&SE organisations, alongside individuals with real life experience, commissioners and potential providers were all involved as equal partners. In a number of events and supported conversations the procurement process supported an approach to ‘think outside the box’. Service design conversations happened within community organisations and settings. All partners were focused on how the gifts, capacities, life experiences and skills available within local neighbourhoods could be brought into the new service. Self-care and peer support approaches within the community were clearly valued. It is the matching of these VCF&SE capabilities with clinical expertise, the use of shared  resources and patient education around emergent digital health tools  which has created an exciting new partnership to support patients experiencing chronic pain.”
Greg Mitten, Chief Officer at West Lancashire Council for Voluntary Services

“I really felt that my point of view was taken seriously, that the CCG really listened to what myself and the others involved in the engagement process had to say and that our views and suggestions were being considered.

 “As a patient who has complex chronic pain health needs and with the existing service being so far from home, having a local service that is aware of the complexities of my conditions will be very helpful, less stressful and much more convenient. I’m very much looking forward to seeing this new service going live and how it will be shaped.”
Patient

“My wife and I felt that we were engaged with regularly and that our views were taken seriously. The fact that our views were being considered and we weren’t simply being advised of what the service would look like was very encouraging. It was clear that with regards to the chronic pain service, no assumptions were being made on how it needed to look.”

“My wife has lived with chronic pain for more than 35 years, and at times it felt as if her treatment wasn’t necessarily going anywhere, but it is clear that there is a renewed emphasis and an appreciation of the need for this service and we are very much looking forward to seeing it get off the ground.”
Carer

“Living with chronic pain is not pleasant for anyone, which is especially why it’s so important we have the right services in place and that they are accessible for everyone. GPs have been trying to manage these patients in primary care with some referrals to hospital without the availability of any holistic support. This innovative specialist service will support those patients addressing their specific individual needs.”
Dr Vik Mittal, Clinical lead for the project and Clinical Executive Member for West Lancashire Clinical Commissioning Group

“With the help of our patients, who kindly took the time to share their views with us and our local clinicians and other partners, we have achieved what we set out to do and can now start offering this service from the Spring of 2019.”
Mike Maguire, Chief Officer, West Lancashire Clinical Commissioning Group

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