Nottingham City Council has approved a substantial increase in funding for its Infection Prevention and Control (IPC) service in residential care homes across the city.
The decision, which was made on July 10, 2023, will see an expenditure of £232,614 spread over three years, starting from April 1, 2024.
It comes at a critical juncture as the existing contract for the IPC service is set to expire on March 31, 2024, with no further extensions possible.
The current contract, valued at £39,581 per annum, supports 52 residential homes across Nottingham City. However, the increased funding will allow for an expansion of services, including outbreak management, IPC training, and regular auditing of homes.
The decision also includes the establishment of an S76 agreement with Nottingham and Nottinghamshire Integrated Care Board (ICB).
The ICB is currently responsible for commissioning IPC for nursing homes across Nottingham city and has a contract with CityCare for their service until March 31, 2027.
The decision to increase funding was influenced by the COVID-19 pandemic, which led to the approval of up to £189,090 for an enhanced IPC service for a period of 12 months commencing April 1, 2022.
The pandemic has increased the demand for IPC services, with a 50% increase in outbreaks noted. The new contract is expected to reflect this increase.
The increased funding will also allow for the introduction of mandatory auditing and follow-ups, a measure that has been welcomed by residential homes.
Feedback from these homes indicates that the auditing process has been informative and supportive, helping them manage infection prevention and control more effectively.
The decision was taken by Lucy Hubber, Director of Public Health, under the Scheme of Delegation Reference Number 1. The decision is classified as operational as it falls within the recurrent IPC line within the Public Health Grant spend and is under £249,999.
The Nottingham City Council believes that the increased funding will allow the IPC service to respond to the current demand more effectively, taking more preventative measures for residential homes and helping to control infection outbreaks more efficiently.
Additional Details
A procurement options appraisal was completed to inform the recommendations after the commissioning review. The options considered included a direct award (which was not possible), going out to procurement with an open procedure, a Section 76 with ICB, and joint commissioning with Nottingham County Council.
The review concluded that it was not operationally viable or financially best value to deliver a service solely to residential homes and separate it from residential homes across Nottingham City. The service is only able to deliver as part of a larger service delivering across nursing & residential care homes as occasionally residents can be placed within the same home.
The review also found that there are some post-pandemic work streams that would be advantageous to keep, the focus being to keep mandatory auditing and follow-ups. Since auditing has been introduced, residential homes have fed back how useful and informative this has been and that they feel supported and more skilled in managing infection prevention and supporting in controlling infection/outbreaks.
The ICB has confirmed that they are happy to do a contract variation and add Nottingham City Council’s IPC service to residential homes to their current contract with CityCare under a Section 76. The City Council will pay the ICB for the continuation of the service until their contract ends on March 31, 2027.
The decision is to seek approval to spend £232,614 (£77,538 per annum for 3 years). This is due to a 50% increase in outbreaks so the new contract is expected to reflect this at £59,372, plus another £18,166 per annum on the current contract value for auditing. The current contract is insufficiently sized and is only able to provide a limited reactive service to care homes experiencing an outbreak. Increasing the per annum contract value will allow for additional preventative elements to be included within the service specification, most importantly ensuring that auditing and follow-ups are an essential part of the service.
The decision is expected to significantly impact the quality of care in residential homes across Nottingham City, with the increased funding allowing the IPC service to take more preventative measures and respond more effectively to the current demand.
