New procurement framework for hospital-at-home technology

NHS SBS has a new technology framework, for the procurement of remote patient monitoring solutions

NHS Shared Business Services (NHS SBS) brings a new framework agreement to the market enabling health and social care providers to procure remote patient monitoring solutions that can reduce the burden on the NHS, at pace. Comprising lots endorsed as recommended buying channels by NHS England’s Central Commercial Function, it comes at a time that sees longer hospital waiting times, hospitals being fuller than pre-pandemic and a discharge crisis. Consequently, the use of technology like connected medical devices, monitoring apps and video consultations – which enable remote monitoring and treatment of people with long term conditions at their place of abode, is being ramped up in a bid to create virtual wards and free up more hospital beds for those who most need them.
The coronavirus pandemic forced many hospitals and social care providers to suspend their routine and elective activities, creating a backlog of patient appointments. Longer hospital waiting times have been exacerbated by discharge difficulties.  As many as one in three hospital beds in parts of England are occupied by patients who are well enough to be discharged but a chronic lack of social care means many do not have suitable places to go.
Given 19 out of 20 hospital beds are full, and 14,000 are being occupied by someone clinically ready to leave but unable to be discharged to the appropriate care setting, NHS England (NHSE) has, in its delivery plan for recovering urgent and emergency care services, stated “its ambition to improve to 76 per cent of patients being admitted, transferred or discharged within four hours by March 2024”.

Virtual wards
The plan also sees virtual wards (hospital-level care at home) playing an important part in expanding capacity by joining-up health and care outside of the hospital.
Virtual wards combine technology and remote monitoring and advice to allow hospital-level care, including diagnostics and treatment. They can also replace the need for admission and facilitate people being able to leave hospital sooner, safely. As such, NHSE is looking to deploy virtual ward beds to scale up capacity from 7,000 to 10,000 in autumn, ready for winter.
Integrated Care Systems (ICSs) bring together providers and commissioners of NHS services like hospitals and GP practices, local authorities and other partners (including charities, voluntary, community and social enterprise organisations), to collectively plan and deliver health and care services to meet the needs of their respective populations.  
As part of NHSE’s ambition, ICSs are expected to deliver virtual ward capacity equivalent to 40-50 virtual ward beds per 100,000 people by December 2023, with virtual ward services developed across ICSs and provider collaboratives, rather than individual institutions.

NHS SBS has designed the second iteration of its framework agreement, Technology Enabled Care Services, in response to the need within the NHS and social care sector to free up beds, reduce the backlog of appointments, speed up patient discharge, and reduce the burden on the stretched social care sector.  
Launched in January, the £150 million framework agreement was created in collaboration with NHSE’s Transformation Directorate, local authorities, national technology enabled care (TEC) policy makers like TEC Cymru, as well as industry bodies including the TSA (TEC Services Association). It focuses on three key themes; Remote Clinical Monitoring, Patient Empowerment and Social Care monitoring.

Organisations can choose to purchase goods and services from 19 carefully selected best-of-breed suppliers, each of whom have undergone a competitive and rigorous selection process in order to be included on the framework agreement.
The free-to-access framework agreement provides a convenient, compliant and cost-effective method of purchasing technology enabled care for all publicly-funded organisations, including GP Practices, hospitals, health centres, emergency services, housing associations and local authorities. Suppliers can introduce any additional new products and services that meet the standards set out and are within scope throughout the framework agreement’s lifetime.   
The framework agreement is categorised into 6 Lots (service types), each representing a combination of goods and/or services which can largely be defined as either clinical (for the NHS and healthcare organisations) or social care-based (for local authorities and housing associations).

The core elements include:

Remote Clinical Monitoring (including Virtual Wards)
Remote clinical monitoring platforms and services connect to vital sign devices that aid in the monitoring, reporting and analysis of a patient’s acute or chronic condition from outside the hospital or clinical setting, for instance, blood pressure or blood glucose levels. They facilitate real-time understanding of a patient’s disease state, enabling clinical decisions to be made.

Alarm Receiving Centre Platforms
These software platforms allow the remote connection of telecare and telehealth devices like movement sensors which aid in the detection of falls, raising an alarm call if unusual activity is detected, or pill dispensers which release medication at the appropriate time, triggering an alarm if it is not removed from the dispenser.

Digital Alarm Services and Peripherals (social alarms)
Facilitate the automatic and remote non-clinical monitoring of individuals using a combination of behavioural and environmental sensors, alarms or other means linked to a communications device. Collectively, they help manage risk and support independence.
Social alarms include pendants which users can activate to call for assistance in urgent situations, through to wireless systems which can detect possible problems with smoke or gas. Sensors automatically raise an alarm alerting a monitoring centre which contacts a carer.

Intelligent Activity Monitoring
A non-intrusive system of sensors, machine learning and automatic data communication to facilitate monitoring ‘activities of daily living’ and detect deviations from previous patterns - crucial to assessing the ability of an individual to live independently in their community and in the early detection of upcoming critical situations. The data generated can capture insights that pre-empt longer term subtle changes in behaviour.   

Patient Controlled Personalised Healthcare Records
Allow individuals to access their healthcare record and related data in one place. The supplier solutions on offer are complementary to the NHS App and can empower the patient/citizen to add, access and share their health information with healthcare professionals in various settings.   

Combined Solutions
Designed to enable procurement of a combination of digital solutions from suppliers on the framework agreement.

Routes to procurement
There are two routes to procuring services using the framework agreement – further competition or direct award. The direct award route allows the purchaser to award a contract directly to a supplier, enabling them to obtain goods and services at speed.
The further competition process (sometimes called mini-competition) re-opens competition under the framework agreement. Procuring parties can ask suppliers listed to submit proposals and costings to help select the most appropriate products and services and drive further efficiencies.
Adam Nickerson – head of category, digital & IT procurement frameworks at NHS SBS said: “The coronavirus pandemic added to waiting lists and the knock-on effects of a lack of beds in the NHS and social care sector. The Technology Enabled Care Service framework agreement enables ICSs and provider collaboratives - from housing authorities to local authorities, to strategically source and quickly buy a mixture of goods be it a single, bundled or a fully managed service, which works across a region. It means they can better plan and deliver joined up services and improve the health of the population across their regional wing of care.”

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