Purpose

Home First Positive Step Adult Social Care Assessment Unit is currently located in Bentley. The service forms part of the Home First suite of services supporting hospital discharges and avoidance providing a total of 30 short term assessment placements.
Positive Step has a contract with Don Valley Healthcare (Bentley Surgery) which is
due for renewal August 2026. This 24-hour service supports the setting providing planned and unplanned cover. The service continues to provide a fast turnover of admissions and the complexity of the patients remains complex with significantly increased levels of acuity.
Due to the increased pressure across the system within Doncaster, the GP
contract provides additional medical support to Positive Step. The service would not be able to function safely without this cover and it is imperative that the Council continues with the current GP contract arrangements for the GP intervention in the setting.
At present the GP contract is delivered by Don Valley Healthcare (Bentley Surgery). They currently provide a weekly on-site ward round, callout in emergency situations, telephone advice and repeat and new prescriptions during the hours of Monday to Friday. The contract has a level of flexibility built in so that it can be flexed to meet the needs of the service.
This contract has worked well and is due to expire 31st July 2026. The continuance of the GP contract is essential for reducing the risk to patients and possible readmissions, the ability to accept referrals from the more complex patients,reducing the need to restrict beds and reducing the length of stay.
Positive Step is currently funded by the Better Care Fund and this cost will be managed from within their BCF allocation to fund the medical cover which is estimated circa per year based on the last year’s spend (from August 2024 to July 2025 plus requested uplift of 3%).

Decision

To direct award in line with Provider Selection Regime a contract for GP Service for Positive Step Social Care Assessment Unit. The value of the service will be approximately per year based on the last year’s spend (plus requested uplift of 3%) for an initial period of 24 months with an option to extend for a further 1 x 12 months, taking the potential contract value to approximately (for potentially 3 years)

Alternative options considered

Option 1 – (recommended Option) direct award the contract under the PSRs
(procedure A) for a GP Service at Positive Step Social Care Assessment Unit
This will support the continuation of the unit to function safely and to manage the level of complex patients effectively, preventing unnecessary hospital readmissions and support avoidance and admissions to longer term residential care.
This has been a historical arrangement and going forward we would look to work with the South Yorkshire Integrated Care Board (SYICB) to ensure that the NHS are supporting GP Service as with other community care settings.

Option 2 – Reprocure the contract for a GP at Positive Step Social Care Unit
The Council have reprocured this both in 2022 and 2024 under CPR 2105 rulesbut unfortunately due to the low value and placement of Bentley Surgery, the only valid interest and subsequent acceptable bid has been from Bentley surgery.

Option 3 – Decommission the contract for a GP Service at Positive Step Social Care Assessment Unit
This will result in an increased number of hospital readmissions, placing greater pressure on the acute services at a time when acute beds are scarcely available.
The unit would not be able to accept patients with complex needs and as such the number of delayed discharges would increase. The safety and wellbeing of the patients would also be brought into question.