Delivering SARCs across the South West of England is a highly complex, sensitive and multi-organisational project. Commitment and buy-in from senior personnel within the Police, Offices of the Police and Crime Commissioner (OPCCs) and NHSE Commissioners required dedicated governance and leadership from our procurement team.
They were able to forge a partnership enabling previously challenging barriers such as integration, service alignment and funding flows to be collaboratively and effectively resolved and created a platform for effective joint contract management.
Challenge
The aim of a SARC is to provide a service to ensure that victims of serious sexual assault, including rape, receive appropriate urgent medical care and access to counselling, and if they choose forensic examination to provide evidence to assist police in a criminal investigation.
Throughout the process, consideration was given to the local environmental and social needs of the South West area. The specifications were designed to ensure service user needs were met, taking account of each area’s demography and the broader pathways and systems.
Solution
Comprehensive market assessment and engagement were undertaken with 43 providers who operate across the south region delivering in-scope and out-of-scope services, to obtain a holistic view. A Prior Information Notice followed by an extensive survey and provider meetings helped to inform the re-commissioning strategy. It provided feedback on opportunities and barriers to entry, cross-border working, lotting, contract length, mobilisation, staffing and recruitment, integration of SARC and Sexual Offence Examiner (SOE) provision and preference of future engagement formats.
Keeping the voice of the service-user (victims) at the heart of the re-commission was imperative and achieved by ensuring a service-user was an active member of the recommissioning board. They were able to influence the development of the specification of the assessment criteria and were an integral member of the evaluation panel at all stages of the process.
The procurement approach adopted by the team was a two-stage process designed to assess and assure the capability of providers and to embed innovation and integration into the heart of the selection process. Success was determined as delivering people-oriented and focused services that would address the needs of service users for this highly emotive service.
Integrating SOE provision within the main SARC contracts has allowed for consistent contract management within each of the force areas. This will enable SARC providers to have control over the core elements of the pathway to provide consistent provision resulting in greater consistency and improved quality of services for the service user.
This integration has achieved greater access to the finite, specialist staffing resource required to undertake forensic examinations. As well as an increased pool of staff, there is also now contingency for sharing staff across borders, if required.
Potential providers were assessed by multi-organisational evaluators including service users to ensure they could deliver consistent, high-quality services for different age groups, i.e., adults and paediatrics
Impact
- Building on work already undertaken over the life of the first-generation contract, the SARCs are now encouraged to work as part of a regional network, to facilitate access across Force boundaries, increasing flexibility of access for service users and aiding the sharing of clinical expertise and resource. This regional approach, incorporating clinical networks, will contribute to greater consistency of standards and quality of care.
- Consolidation of South West cross-county provision has enabled staffing/resource efficiencies across the two paediatric SARCs, greater sharing of expertise and enhanced cross-border access to services across the two regions (the North of the patch - Avon & Somerset; Gloucestershire and Swindon & Wiltshire; and the South of the patch - Devon & Cornwall). Responsibility for onward referrals has been clarified to ensure consistency across the region.
- The senior clinical staffing model used aligns with best practice and will maintain the quality of paediatric staffing and delivery.
- Due to the geography of Avon & Somerset, and with the Force area’s SARC being based in Bristol, for service users within Somerset, their preference may be to travel less distance to the SARC in Exeter (within the Devon & Cornwall Force area). Enhanced collaboration across providers in each of the Force areas has enabled the sharing of clinical expertise as a contingency option in the event of staff shortages which led to improved access for service users in Somerset.
- All SARCs must be accredited by October 2023 - a new requirement set by the Forensic Service Regulator (FSR) and the United Kingdom Accreditation Service (UKAS). There are several dimensions SARCs have to take into account to achieve accreditation. Within the South West, a regional approach to achieving this has been developed to allow for consistency of approach and learning to be shared.
- Additional funding was allocated to the new contracts to enable providers to meet increased post-covid demands ensuring sustainable service provision.
- The national team for SARCs are developing a Capability Framework for the Paediatric Workforce, to provide greater clarity on the level of expertise and qualifications expected to undertake forensic examinations, whilst recognising the finite resource in this field. The commissioning of these services and the specification took this into account, allowing for flexibility to adapt the workforce requirements, as and when deemed appropriate in line with the Framework.
As well as improving equality of service and access provision, our team recognised the fundamental need to increase awareness of SARC services via campaigning, and better use of websites and social media to the public/ professionals/agencies. We have continuously shared our approach/documentation and learning from the excellent collaborative work undertaken in the South West with procurement colleagues in South East/North/Midlands to ensure all can benefit and accelerate improvements in the provision of these highly sensitive services.
This has been a high quality and innovative procurement approach of two stages, whilst ensuring that the process itself was inclusive and robust. Critically, it enabled people with lived experience to be central to the process, and our criminal justice partners have expressed their appreciation and trust in the approach. This has not only served the recommissioning process well, but also established positive relationships that enable continued joint commissioning between NHSE and partners - Steve Sylvester, Director of Specialised Commissioning, NHS England
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