Cabinet to consider Virgin Care contract extension

Bath & North East Somerset Council’s cabinet is to consider extending Virgin Care’s contract to provide adult community health and social care services, children’s health services, and some public health services.

As joint commissioners, the council and Bath and North East Somerset, Swindon and Wiltshire Clinical Commissioning Group (BSW CCG) awarded Virgin Care a seven-year contract in 2016 with the option to extend for a further three years to 2026/27. This award followed a two-year joint review of community services that included extensive public engagement and led to developing a new model for health and care community services that informed Virgin Care’s transformation programme.

A report to go before cabinet on Thursday 11 November recommends extending the contract but transferring two services back to the council and the CCG.

Since April 2017 Virgin Care has been responsible for a wide range of services to support people in their community who, for example, have diabetes or dementia or who have respiratory problems or suffered a stroke; children with learning difficulties or life limiting conditions; people with complex needs; and elderly people undergoing rehabilitation after a stay in hospital.

The organisation’s community public health functions include helping people to stop smoking and supporting parents to give their children the best start in life. Through its school immunisation programme, commissioned by NHS England and Improvement, Virgin Care is currently playing a key role helping to stop the spread of Covid-19, by offering vaccinations to 12–15-year-olds.

The report to cabinet outlines Virgin Care’s performance, including customer feedback and details of areas requiring improvement. It recommends extending the contract but returning Virgin Care’s responsibilities for strategic safeguarding and Continuing Health Care (CHC) to the council and CCG respectively. This would streamline safeguarding services between Virgin Care and the council and the transfer of the CHC service to the CCG would bring it in line with CHC arrangements for Swindon and Wiltshire.

Councillor Alison Born, cabinet member for Adults and Council House Building, said: “We recognise that the past two years have been incredibly challenging for those working in community health and social care, supporting some of our most vulnerable residents. The pandemic has reinforced how important these services are and we must ensure they are delivered to the highest standards. We will therefore consider the report carefully before reaching a decision.”

Dr Brynn Bird, GP and B&NES Clinical Lead at BSW CCG said: “The option of a contract extension was included as part of the original contract between Virgin Care, B&NES Council and the CCG when it was awarded five years ago. But it’s important that we act in the best interest of our local population and I’m pleased that such a detailed and balanced report has been prepared for the Cabinet and CCG Governing Body to consider on 11 November.”

Virgin Care is currently responsible for a range of services including two community hospitals, outpatients’ clinics, school nursing and immunisation services as well as wellbeing services and some social care services.

The report to cabinet says regular monitoring of these services has found that overall they are well run by Virgin Care and its contractors. It says the offer to residents has improved following changes to service delivery, for example upskilling physios to support consultants delivering Botox therapy to reduce waiting lists within the Community Stroke and Neurological Service and embracing new technologies within public health to support people wishing to stop smoking.

The performance of Children’s Community Health Services is highlighted as consistently performing strongly: managing resources effectively and delivering high quality services across the board including receiving a ‘Very Good’ rating for the support provided to children with Special Educational Needs and Disabilities.

One of the biggest drivers of improvement has been the establishment of a Care Co-ordination Centre to help residents navigate the health and care system by providing a single point of access. The centre, set up by Virgin Care in Peasedown St John, receives hundreds of calls every day with teams of social care and health professionals on hand to provide advice and signpost to appropriate services.

Virgin Care has also been instrumental in leading the development and operation of the Community Wellbeing Hub in conjunction with colleagues from 3SG, their members, BSW CCG and the council. The Hub was set up as an emergency response to Covid-19 providing a single point of access for anyone seeking support or guidance. Since the onset of the pandemic Virgin Care staff have triaged more than 15,000 calls to the Hub with response teams providing a range of support including food support, welfare support and mental and physical wellbeing advice and support. The Hub has proved so successful it will now provide an ongoing service for a joined-up community response to support the wellbeing of residents.

During 2019/20 Virgin Care:

  • provided 52 community services supporting 40,268 people

  • carried out 278,209 face-to-face appointments

  • supported 14,562 calls from the Community Wellbeing Hub

Virgin Care has also delivered on a key initial transformation priority to develop a system to allow practitioners to appropriately share an individual’s records to ensure the best decisions are made about their care. Integrated care records are now being rolled out across Bath and North East Somerset.

However, the report to cabinet also identifies some service areas that require improvement such as assessment and review waiting times in Adult Social Care; diagnostic waiting times in Community Services, which fall below national standards, and length of stay times in Community Hospitals.

The report also highlights the fact that some services are being affected by recruitment issues and throughout its five-year contract Virgin Care has consistently found its ability to carry out Continuing Health Care assessments within the national target of 28 days challenging.

The report also recommends identifying clear performance improvement plans for some services provided by Virgin Care.

It's against this backdrop that cabinet is being asked to consider whether Virgin Care should continue to provide community health and social care across the district from 2024 – 2027.

As joint commissioners BSW CCG and the council must reach a decision and inform Virgin Care by March next year.

The BSW CCG Governing Body will also meet in public to discuss the report on Thursday 11 November and details of their meeting are available here

The Council’s Children, Adults and Young People Policy Development and Scrutiny Panel will also consider the report at its meeting on 9th November.

View the report to cabinet

Cabinet will meet informally via Zoom at 6.30pm on Wednesday 10 November to discuss the report before making a formal decision at its meeting at 11.30am on Thursday 11 November. You can watch both meetings live or view them later on the Youtube channel.