Cheshire West and Chester Council is coming under intense pressure to reverse a decision that doctors fear will put patients at risk.
Consultants, NHS bosses, GPs and a national charity are backing their internationally respected Chester-based colleague Dr Colm O’Mahony and his team after the contract for sexual services in the borough was transferred to East Cheshire NHS.
The council say the East Cheshire bid was preferred “because it was considered to provide a better quality, more innovative service” but at the moment nobody knows where facilities will be based when the service commences on February 1.
In 2013 the council commissioned a Sexual Health Needs Assessment which gave current provision a big thumbs up. Overall, 88% of respondents said they would recommend the service to a friend.
Sexual health consultant Dr O’Mahony, who is based at the Countess of Chester Hospital, told The Chronicle: “Clinical colleagues are dismayed that the decision will see the break-up of an award-winning, internationally renowned sexual health team which is based at the Countess of Chester NHS Foundation Trust who also run outreach clinics in schools, doctors’ surgeries, Chester University, and in the community.
“We work closely with other departments in the hospital and, without a dedicated hospital based HIV unit, patients with the condition will have to be referred to Liverpool.”
Dr O’Mahony, who has appeared as a sexual health expert on a TV series hosted by Davina McCall and Stephen Fry, added: “We see 7,500 patients each year in the hospital and another 7,000 in the community – from young mothers and their new-born babies who have contracted HIV and need continuous care and massive emotional support, to people who need contraception and family planning advice.
“We’re concerned that they don’t know where to go and our staff, who will be moving to the new provider, don’t know where they’re going to be based either.
“I am worried that we’ll see an erosion of the tremendous advances which have been made in fighting sexually transmitted infections, teenage pregnancy, and HIV as well as safeguarding issues.
“From February 1 clinicians and patients don’t know where sexual health care will be based. They are concerned that the care will be fragmented, more difficult to access and in some cases, not available at all. After the Christmas holidays we will see a massive surge in people worried about sexual health. We can’t afford to let them down.”
Last week an extraordinary meeting of the medical staff committee representing senior clinicians at the Countess unanimously voted to oppose the changes and the body may mount a legal challenge to the process which has been described as “a paper exercise” with no consultation with local GPs. The only medical input came from one GP, from outside the area, with a specialist interest in sexual health.
“Would a locum GP who once worked in surgery eight years ago be considered suitable as the only doctor on a panel to assess a tender in cardiac surgery? No! Then why accept it in a tender for sexual health?” added Dr O’Mahony.
The Chronicle has copies of letters voicing concerns from clinicians including Dr David Wilson, consultant in emergency medicine at the Countess, Dr Helen Gillies, a GP at Farndon Health Centre and Huw Charles-Jones, a Lache GP and chairman of the West Cheshire Clinical Commissioning group which funds the local NHS.
Marian Nicholson, director of The Herpes Viruses Association, wrote to health minister Jane Ellison MP: “It is the view of this charity that the service provided in Chester is one of the finest in the country. From the end of January 2015, the service will be provided by a trust with no experience in the area, without the benefit of existing dedicated buildings, operating at an as yet unknown location and at no saving to the taxpayer.
“It is incomprehensible that the council has made this decision without expert advice and without any consultation or the involvement of the local GPs in the area.”
Mark Brandreth, deputy chief executive at the Countess, is “disappointed” by both the outcome and tender process with no word yet on where the service will be based.
He added: “We are seeing an increasing number of enquiries from regular service users about where and how they will access services in 12 weeks. In view of the short timescales ahead of the transfer to the new service arrangements, we are seeking clarity around this from East Cheshire NHS Trust as a matter of priority.”
Cllr Louise Gittins, shadow portfolio holder for health and wellbeing, said: “We have a number of concerns around the commissioning process that took place prior to the awarding of the sexual health contract.
“Last Friday we posed a number of questions to Cheshire West and Chester Council and are still awaiting a response. This seems to be an ongoing trend within the council for recommissioning of services. There appears to be a lack of transparency and openness in the process and the way in which decisions are made.”
Cheshire West and Chester Council hits back over claims sexual health service will suffer
The East Cheshire bid was preferred because it was “considered to provide a better quality, more innovative service”, according to Cheshire West and Council who awarded the sexual health services contract.
But council spokesman Ian Callister confirmed no locations for service delivery had so far been selected for the new provision which begins in eight weeks’ time.
He said: “In offering a more community-focussed and better integrated model, it fulfilled one of the major objectives for the new service. Currently sexual health services in West Cheshire are provided by three NHS community health and one voluntary sector provider.”
Backers of the rival NHS bid, involving the Countess, Mid-Cheshire Trust (Leighton Hospital) and Body Positive, claim the tender process had to be re-run after East Cheshire initially bid £2.8m – £400,000 more than the maximum amount allowable.
The maximum was then increased to £2.8m and East Cheshire won in the re-run round with a winning price of £2.75m – compared with £2.5m tendered by the competing bid.
Council spokesman Mr Callister explained: “With regard to the acceptance of a £400,000 higher bid in the first tender process: a number of factors other than contract price were taken into consideration in reaching a final decision. Tenders are awarded on the MEAT principle (Most Economically Advantageous Tender) scored on a combination of price and quality - in the case of this tender it was evaluated at 30% price and 70% quality.
“Consequently, offering the lowest price does not necessarily guarantee success if the quality of your proposal is not of sufficiently high a standard in comparison to other bids.”
Mr Callister said the decision to re-run the tender process was because of a minor ambiguity in the wording of two documents which “could have caused confusion for bidders”.
“It was felt that in the interests of fairness and transparency it would be better to re-run the process,” he said.
Tackling concerns over the lack of medical experience on the awarding panel, he added: “Claims that there was no medical person on the initial assessment panel are unfounded. Assessment of the first tender was carried out by a panel with a range of expertise in sexual health services and included representatives from NHS England and Public Health England.
“The second tender saw that panel augmented by the addition of a GP who had a special interest in sexual health services and had previous clinical experience within in a GUM service.
“While the response to the tender was developed without consultant support because of the long term absence of the lead consultant, the approach was designed using a multi-disciplinary team of specialists in sexual health, clinical nurse specialists in sexual health, genito-urinary medicine and HIV and supported by teams from clinical support areas.”
East Cheshire NHS Trust spokesman Chris Gorman said: “We are very pleased to have been selected to provide sexual health services in west Cheshire from next year.
“We hope to build on our substantial experience providing similar services in east Cheshire. This gives us an opportunity to create an innovative new service model.
“We are working closely with the Countess of Chester NHS Foundation Trust and Cheshire West and Chester Council to ensure a smooth and safe transfer for staff, patients and services.”