Issue - decisions

Medically Managed Residential Drug & Alcohol Detoxification Service

13/03/2019 - Medically Managed Residential Drug and Alcohol Detoxification Service

The Cabinet considered the report of the Head of Health and Wellbeing which provided details of proposals to implement a two-year extension of the current contract with Mersey Care NHS Foundation Trust for the provision of the Medically Managed Residential Drug and Alcohol Detoxification Service.

 

Members of the Cabinet expressed the view that the provision of the service should be mindful of the current work taking place within the Liverpool City Region on the Housing First Initiative.

 

Decision Made:

 

That the Head of Health and Wellbeing be granted authority in consultation with the Cabinet Member – Health and Wellbeing to exercise the option to extend the current contract with Mersey Care NHS Foundation Trust for a period of two years from the 1 July 2019.

 

Reasons for Decision:

 

The Cabinet on 1 October 2015, authorised the Interim Director of Public Health and Chief Finance Officer to award the contract for its core period from 1July 2016 and authority was required to exercise the extension options outlined in the tender exercise.

 

For the past two and a half years, Mersey Care NHS Foundation Trust have provided Medically Managed Residential Detoxification Services that meet or exceed contractual and performance targets. For example, the threshold for successful detoxification completions is set at 80%. In Quarter 4 of 2017/18 the service achieved 81%; in Quarter 1 of 2018/19 86% and in Quarter 2 of 2018/19 90%. The threshold for service users rating their satisfaction as good or excellent is set at 80%. In July, August and September 2018 the service achieved 100%. Public Health Commissioners have no concerns over the quality, performance or governance of the current service. 

 

Mersey Care have recently invested heavily in a refurbishment and upgrade of the Hope Centre Detoxification Centre. The Centre now offers modernised accommodation, bespoke therapy rooms and a Barnardo’s approved children’s area.

 

Authority to exercise a two-year extension option rather than a one-year extension was recommended to ensure on-going service stability and improvements in outcomes / performance being sustained in the longer-term.

 

Medically Managed Residential Detoxification services are highly specialist and experience from previous tender exercises show choice within the local and regional market to be extremely limited.

 

Conducting a full procurement exercise at this point would not bring about any significant benefits for Sefton Council or for users of the detoxification service and exercising the option to extend the current contract by one-year would only bring about temporary short-term stability. Exercising both twelve-month extension options together at this point provides the best opportunity for continued service stability and service improvement within an environment of uncertainty and change.

 

Alternative Options Considered and Rejected:

 

The available options are:

 

i)     Exercise one year extension / continuation option. This option would provide a degree of continuity and stability and the value would be within the threshold for Cabinet Member Authorisation. However, any continuity / stability derived from exercising this option would be limited to twelve months at which point the Council would still need to consider exercising the second extension / continuation option or re-tender the service.

 

ii)    combine both twelve-month extension / continuation options and exercise an extension to the existing contract for a period of two years. This option would provide a longer period of service stability and reduce cost to the Council from engaging in a procurement exercise. The value of a two-year extension would exceed the threshold for Cabinet Member Authorisation and a decision would need to be sought from full Cabinet.

 

Conducting a full procurement exercise would not bring about any significant benefits for Sefton Council or for users of the detoxification service.

 

Considerable savings were realised throughout the 2016 procurement exercise with a contract value reduced from £510,522 per year to £374,900 per year. The contract was awarded following robust assessment and evaluation procedures and it was clear that there were only a limited number of acceptable options available within the open market.

 

Medically Managed Residential Detoxification Services are highly specialised services and few exist outside of NHS Trusts. After the current service provider, the nearest provision for medically managed detoxification is in Manchester and does not meet the specified criteria of delivering a service within fifteen miles of Sefton boarder.