Bromley Council plans £25.4m public health nursing tender

Bromley Council is preparing to tender for a new public health nursing service for children aged 0-19, with the contract set to begin on October 1, 2027. The five-year agreement is estimated to cost £5.08 million annually, totalling £25.4 million over its lifetime. This proposed annual figure is below the projected inflation cost of £5.2 million, reflecting a careful review of service components despite national and local pressures.

The decision to re-procure the service follows the expiry of the current contract with Bromley Healthcare on September 30, 2027, with no further extension options available. The new contract aims to align with updated national guidance for the Healthy Child Programme, local population needs, and a more integrated, outcomes-driven model.

The refreshed Healthy Child Programme (HCP) serves as a modernized, evidence-based blueprint for Health Visitors and School Nurses, incorporating updated delivery and commissioning guidance, and a high-impact area framework that requires additional resources for compliance. The Department for Health and Social Care has also issued new operational standards for 0-19 Public Health Nursing services, which will influence the new service specification.

The 0-19 Public Health Nursing Service encompasses health visiting for children aged 0-4, school nursing for those aged 5-19, the National Child Measurement Programme, vision screening, and a supervised toothbrushing programme. These services are largely mandated under the NHS Act 2006 and the Health and Social Care Act 2012, with the exception of vision screening.

Bromley's current service is noted for its high performance, with coverage rates for mandated reviews exceeding both London and England averages. However, the service faces increasing demand and complexity of need, alongside national challenges in workforce recruitment and retention for health visiting roles. The updated Healthy Child Programme outlines additional roles for school nursing teams, such as offering drop-in sessions in schools and providing targeted support to additional groups of vulnerable children and young people.

The new service specification will emphasise early intervention, digital access, workforce sustainability, improved safeguarding pathways, and alignment with refreshed mandated activity from the Healthy Child Programme. The updated guidance emphasizes the use of digital access for pupils in school-aged services, aiming to align assessments and early-help pathways with social care, maternity, and CAMHS for reduced contacts and duplicated casework. This aims to ensure children and families receive comprehensive support, contributing to better health outcomes and reduced health inequalities across the borough.

The 0-19 Public Health Nursing Service is expected to significantly improve child health and reduce inequalities by providing early, proactive interventions from birth through adolescence, covering physical health, mental well-being, and safety. Specific strategies include early identification of developmental delay, safeguarding risks, and health conditions, as well as targeted support for vulnerable families.

The procurement will be conducted under the Provider Selection Regime (PSR) using a competitive tender process. This approach is chosen because the service requires a single provider with the capacity to deliver a complex, integrated service and because market testing indicates multiple potential providers. The tender evaluation will focus on quality and innovation, value, integration, collaboration, service sustainability, improving access, reducing health inequalities, facilitating choice, and social value, with a 60:40 price-to-quality ratio. Social Value will have a 15% weighting in the evaluation.

Key performance indicators (KPIs) for the new service include: 100% mandatory acceptance of referrals within 5 working days; 100% mandatory development of person-centred support plans within 5 working days, reviewed at least quarterly; 100% mandatory support for service users to attend and complete an Annual Health Check with their GP; 100% mandatory registration with all mainstream health services; 95% of staff receiving mandatory refresher training; 100% of appropriately trained and assessed staff available 24/7; 100% mandatory reporting of safeguarding and serious incidents within 24 hours; 95% of complaints resolved to the satisfaction of the complainant; 100% compliance with Deprivation of Liberty guidance; 100% of service users having had a medication review under STOMP; service user satisfaction in the Annual Survey to be >90%; and communication and hospital passports in place and reviewed.