Community Macular Service

North, Central & South Manchester and Trafford CCG commissioners are seeking responses from viable providers who can work effectively across primary, secondary and tertiary care. Assurance of competence, quality, innovation and safety standards are required. An additional commissioner may join the tender process – this will be confirmed at publication of the contract notice.

We wish to commission a high quality, comprehensive and efficient community-based macular service to commence in August 2016. The service will primarily treat wet Age-related Macular Degeneration but also Diabetic Macular Oedema and Retinal Vein Occlusion. We expect the service to demonstrate the following: o A single clinical team, which is consultant led, with clear clinical objectives and an open and transparent audit and performance management framework o A service operating within NICE and Royal College of Ophthalmologist guidance in order to deliver best clinical outcomes by ensuring early first injection and subsequent assured treatment to plan o Clear clinical, patient experience and value for money outcomes jointly monitored by the providers and commissioners o A local accessible service o Educated and informed patients with care plans that they understand o Full shared decision making, particularly around the decision to continue or cease treatment o Streamlined attendances with as average time in the department of <30 minutes o A single integrated team o A shift from a consultant delivered service to one which is consultant-led, but is largely delivered by other suitably qualified clinicians such as specialist nurses and/or optometrists o Ensuring prompt initial treatment and timely treatment to plan beyond that to minimise visual impairment and blindness o The CCGs are currently considering introducing Oraya Therapy as part of the pathway in order to reduce the average number of injections required per patient – if not at the outset then as part of innovation and development of the service. This will be confirmed in the PQQ. Should we include Oraya Therapy in the service the CCGs will ensure that the necessary equipment and training is available to the successful bidder who must be prepared to deliver the treatment in line with current best practice

The service will be for adults (registered with a North, Central , South Manchester or Trafford CCG GP) that meet the referral criteria, who are newly diagnosed from the start of the service. However, it is anticipated that existing macular patients may elect to receive treatment in the new service at some point in the future and the CCG s will work with existing providers to facilitate this choice offer.

We expect the service to be operational by 1st August 2016. The contract term will be for a period of five (5) years.

The commissioners are considering introducing a requirement that all new macular patients be offered Avastin through Choice and would like to seek providers' views.

Additional information: We expect the injection service to be provided within each of the geographical areas of the commissioning CCGs.

The CCG is interested in hearing from providers that can provide either static or mobile service solution and those that are not limited to the standard Monday to Friday 9 - 5pm model.

The commissioners are considering introducing a requirement that all new macular patients be offered Avastin through Choice. In so doing the CCGs wish to emphasise that they are in no way restricting funding for a licensed alternative should the patient so choose. We wish to seek the view of interested parties as to whether they would be willing to offer Avastin as part of this service, through fully informed choice with patients - with no barriers to them choosing a licensed alternative should they wish. When you express an interest in this opportunity please indicate whether you would be willing to offer Avastin through choice, and if so, any caveats which you may wish to apply. If you would be unwilling to offer Avastin through choice, please give your reasons for this.

Further information on Avastin can be found by following the link below:

http://www.cochrane.org/CD011230/EYES_systemic-whole-body-safety-of-bevacizumab-versus-ranibizumab-for-neovascular-age-related-macular-degeneration

To express an interest in providing this service, please email [email protected] by 5pm on Friday 4th December 2015.

The commissioners will consider the responses and the final position regarding Avastin through Choice will be stated with the PQQ documentation once it becomes available.

This will be a restricted tender, and it is anticipated that a contract notice and PQQ documentation will be issued during December 2015. Please note that all information contained within this notice is indicative at this stage. The named CCGs reserve the right to amend or clarify any of the details contained within this notice as part of the tender documentation to be issued at a future date.

Please note that the CCGs are currently seeking to alert the market place to this upcoming tender, and to gauge the level of interest in providing these services. An expression of interest in delivering these services is not a tender response. An expression of interest is no indication of a commitment to participate in the tender process nor does it infer any special status on those providers who do submit an interest. Potential providers who do not express an interest at this stage will still be able to apply in the future. All responses will be treated in confidence. This Expression of Interest does not commit any of the named CCGs to undertake the procurement of these services.