Framework Contracts: examples & issues

Details of some very high-value framework contracts 2014-2023

November 2014: £780 million clinical services

In November 2014, NHS Supply Chain awarded places on a four year "Surgical hospital services" to 11 private companies. The contract had a maximum value of £780 million over four years. The companies listed could be contracted to supply surgery and diagnostic services, both mobile and strategic. Imaging services include bone densitometry, cardiac angiography, CT, mammography, MRI, PET CT, X-ray, ultrasound, and theatre services, including theatre services for cardiology, dental, endoscopy, ENT, General Surgery, and gynaecology. The companies are Alliance Healthcare, Care UK, Circle Health, Cobalt Unit, Diagnostic World Ltd, Inhealth Ltd, Medical Imaging Partnership, Nuffield Health, Ramsay Health, Regents Park Cardiovascular Solutions, and Vanguard Healthcare.

August 2017: £200 million medicine at-home services

Southend University Hospital NHS Foundation Trust awarded places on a framework contract to over 13 companies for mid-tech homecare medicines services, with the award published in August 2017. The contract had a maximum contract of £200 million. The initial period of the contract was two years, but two lots of one year extensions could potentially be awarded.

This includes, but was not limited to, provision of homecare services for the following areas: Hepatitis, Oral Chemotherapy, Self-injectable Methotrexate, Erythropoetin Stimulating Agents (ESAs), and Self-Injectable Biologic Products for Rheumatology, Dermatology, Gastroenterology and Neurology Indications.

The companies awarded places included Healthcare at Home (now Sciensus), Baxter Healthcare, Fresenius Medical Care, Lloyds Pharmacy, One Stop Pharmacy, and Healthnet Homecare.

November 2017: £56 million National Framework Agreement for On-site Surgical and Medical Capacity Solutions

The Countess of Chester Hospital NHS Foundation Trust put in place a new commercial Framework Agreement to procure on-site surgical and medical capacity solutions. The framework contract was worth £56 million over four years. In November 2017 two companies were awarded places on it - Healthcare Business Solutions (UK) Ltd and SHS Partners Surgical Ltd.

The contract award states that the overall aims of contract is to provide "NHS Organisations with fully compliant solutions which supplement the delivery of patient care by NHS Organisations in line with the NHS' core Key Performance Indicators including but not limited to: A&E 4 hour wait targets, elective 18 week Referral to Treatment targets, cancelled procedures targets, bed availability and utilisation targets, timely and appropriate diagnostic testing targets and urgent 2 week GP referral rules for suspected cancer."

January 2019: £105 million NHS Diabetes Prevention Programme (NDPP)

As part of the NDPP, NHS England awarded places to five providers on a Framework Agreement in January 2019. The five providers have to provide, anywhere in England, up to 100,000 behavioural interventions aimed at preventing or delaying the onset of Type 2 diabetes in people with non-diabetic hyperglycaemia (or pre-diabetes) per year for the initial period of the three year Framework Agreement. The Framework Agreement include an option for it to be extended for a further 12 months in addition to the initial 3 year term upon review. The companies will be paid a share of the £105 million allocated to the framework contract.

The companies are Ingeus UK Ltd, Living Well Taking Control LLP, Pulse Healthcare, Reed Momenta, and WW GBR ltd.

January 2019 and September 2022: £100 million remote radiology reporting

NHS England awarded places on a framework for remote teleradiology reporting and auditing services to nine companies in January 2019. The companies are 4Ways Healthcare, Alliance Health, Diagnostic Healthcare, DMC Imaging, Inhealth Ltd, Medica Reporting, Everlight Radiology, Telemedicine Clinics, and Vital Radiology Services. The companies will receive a share of the £100 million allocated to the contract over two years, although the agreement includes an option to be extended for a further 12 months plus 12 months.

A second framework agreement was awarded to 14 companies in 2022, beginning in September 2022, valued at up up £100 million. The framework agreement was listed as running to September 2026, but with a possible 12 month extension.

March 2019: £600 million contract for the provision of patient discharge services

Places on this £600 million Framework Agreement were awarded to a large number of companies, not-for-profit organisations, and some NHS trusts in March 2019 to supply patient discharge services to adults aged 18 and over. The aim is to support hospital discharges for adults and to improve the patient pathway from hospital acute care to an appropriate care setting and therefore reduce delayed transfers of care and unavoidable re-admissions to hospital.

The framework was divided into 3 service lots: Discharge to Assess Services, where people are assessed for longer term care and support in the right place; Third Party Brokerage, where services work personally with families and beyond the traditional care hours model to support people to move to a care home of their choice, step-down care or back into their own homes; and Medical Care at Home, also known as secondary care at home or a virtual ward.

Companies awarded places include Healthcare at Home (now Sciensus), Interserve Healthcare Ltd, Provide CIC, Cera Care, Emergency Personnel Ltd, and the British Red Cross.

April 2019: £600 million Mobile and Strategic Clinical Solutions

NHS Supply Chain awarded places on the framework contract for the supply of Mobile and Strategic Clinical Solutions in early 2019, with the award published in April 2019. It was anticipated that in the first 24 months of the framework agreement the value of purchases would be in the region of £250 million and for the full 48 month term (if extended) the anticipated value is £600 million. The framework was divided into eight lots.

Several lots of the framework cover the production and evaluation of diagnostic images and patient care within a mobile or modular unit. The service can include the provision of at least one member of staff  who must be skilled and fully qualified in the operation of the (imaging) equipment, equipment including any consumables, a booking service; and an imaging reporting service to facilitate clinical patient diagnosis. The types of imaging services included Bone Densitometry, Cardiac Angiography, CT, Mammography, MRI, PET CT, and X-ray.

Other lots cover various surgical procedures and the provision of patient care within a sterile mobile or modular unit, which could include staff, theatre equipment and consumables. The types of mobile/modular theatre services that may be required in this lot include cardiology, dental, endoscopy, ENT, general surgery, gynaecology, lithotripsy, and minors/A & E.

Thirty-four companies were awarded places on the framework including BMI Healthcare, Care UK, EMS Healthcare, Inhealth Ltd, Everlight Radiology, and Vanguard Health.

October 2020: the £10 billion NHS increasing capacity framework

NHS England awarded the first places on the NHS Increasing Capacity Framework in early 2021. The framework includes: NHS inpatient and day case services (including full supporting pathology and imaging) and urgent elective care and cancer treatment in line with nationally set criteria; NHS Diagnostic Services; and Clinical facilities and related services. In fact, the framework covers all hospital-related services. Set up to cope with the backlog due to the cessation of elective surgery during the worst months of the Covid-19 pandemic in 2020/21, the framework signed up a large number of private companies, including the country's largest private hospital companies. The framework was to replace the system of block-booking of private hospital beds that took place during several months of the pandemic in 2020/21. The maximum funding for the four year term of the framework is £10 billion. The framework contract also set in motion the awarding of contracts for Community Diagnostic Centres (CDC).

The contract award notice 2021/S 028-070725 includes the details of 61 suppliers that entered into frameworks agreements in February 2021, then Contract Award Notice 2021/S 028-070725 in April 2021 includes an additional 24 suppliers that have entered framework agreements, making a total of 85 suppliers. A further award notice in June 2021 included more suppliers.

November 2021: £2 billion NHS Workforce Alliance Framework Agreement

This framework contract's full title is for NHS Workforce Alliance Framework Agreement Insourced Services to Support the Provision of Healthcare Services by NHS and other public bodies (including Clinical Services) and covers a four year time frame to October 2025. The contract is described a part of the recovery from the COVID pandemic and is needed to supplement, support and expand the NHS's "in-house capacity through use of insourced service provision".

The framework covers a broad range of clinical and medically related insourcing services, including; diagnostics, diagnostic imaging, cardiology, endoscopy, ENT, general surgery, gynaecology, ophthalmology, orthopaedics, physiotherapy, urology, dermatology and all other specialities and functions.

In November 2021, places on the contract were awarded to 37 suppliers, including Healthharmonie Ltd, ID Medical Group, Medacs Healthcare, Omnes Healthcare, and Totally Healthcare. The framework is opened every six months for further companies that fulfill the criteria to be added to the contract.