Tier 2 and Macular Community Ophthalmology Service

NHS Greater Preston Clinical Commissioning Group (CCG) and NHS Chorley and South Ribble CCG are seeking expressions of interest from suitably qualified and experienced organisations to deliver a high quality, comprehensive and efficient community based Tier 2 and Macular (Wet AMD and other similar conditions such as Diabetic Macular Oedema (DMO) and Retinal Vein Occlusion (RVO)) Ophthalmology service.

The existing contract for the Tier 2 service is due for renewal and Wet AMD treatment is currently not provided locally. This opportunity has been used to review what is currently delivered and expand the service model that is provided for patients; including a Wet AMD treatment service locally and to include the utilisation of Anti VEGF treatments for DMO and RVO in the new service.

The CCG’s wish to appoint a single provider for the provision of each element of the service

Lot 1: The Tier 2 Service; and

Lot 2: The Macular Service

to deliver the services across the combined CCG areas.

Timely local access to the service will enable GPs and Optometrists to refer patients quickly for expert opinion and diagnostic investigation without the need for the patient going into hospital. This will improve clinical outcomes for patients.

The service shall be delivered out of community locations in Preston, Chorley and South Ribble. This procurement will be split across two lots as below:

Lot 1: The Tier 2 element of the service will manage acute conditions including the following:

•Lids, Lashes, Tears;

•Red Eye and Red Eye Corneal Conditions;

•Vitreous;

•Raised Intraocular Pressure (IOP’s);

•Blurred vision / field defects / retinal lesions / lens capsulotomy / minor surgery;

and

•Glaucoma

Lot 2: The Macular element of the service will provide patients with clinical assessment, diagnostic and treatment services for patients presenting with the following conditions:

•Wet AMD

•Diabetic Macular Oedema (DMO)

•Retinal Vein Occlusion (RVO)

The CCGs wish to include the use of Avastin in scenarios where it can be legally offered in the patients best interests. The provider will agree these scenarios with the commissioner.

NICE will publish a new AMD diagnosis and management guideline in August 2017. The CCGs understand that routine use of Avastin is covered in the guideline scope and the CCGs position will be reviewed at this point.

This is for a contract for 3 years with an option to extend for a further 2 years.

Anticipated contract start date is January 2017

Additional information: The overarching objectives of the service are to:

•Have Consultant Ophthalmologists at the core of the delivery responsible for ensuring that continuity and consistent quality of care is delivered by all members of the community Ophthalmology team. •Ensure patients are seen and treated in the right place at the right time and by the most appropriate person

•Ensure that all patients have their initial treatment quickly and all subsequent treatments to plan

•Operate under a substantially lower than existing but sustainable tariff offering Value For Money (VFM)

•Offer new technology and treatments as they become available, for example Oraya Therapy, for all those who are eligible for it

•Ensure pro-active shared decision making (SDM) for patients and carers

•Ensure that Clinical practice/treatments are in line with the current

research/evidence-based care, ensure adherence to NICE Guidelines and/or any relevant locally developed guidance and evolve as the evidence evolves.

•Ensure that patients have a positive experience of care resulting in improvements in patient satisfaction.

•The service will ensure that all treatments are compliant with the Effective Use of Resources.

•A fully inclusive service will be available to all communities and, where necessary, make reasonable adjustment for individuals with cognitive, emotional and physical impairments.