Addressing Misconceptions around the GP Out of Hours Procurement Process

Following the announcement on Monday 3 February 2025, concerning NHS Shropshire, Telford and Wrekin’s (NHS STW’s) intention to award the GP Out of Hours Service contract to Medvivo, we are aware that a number of misconceptions are being shared which has understandably been causing concern for local residents.

The following document provides important information and aims to correct misconceptions by extracting sections from the GP Out of Hours service specification, which has been in the public domain since October 2024. As a commissioning organisation, NHS STW produces service specifications to clearly define expectations and the standards of care we require from our providers.

We want this document to clarify important points around the GP Out of Hours procurement process and provide reassurance to those who may be concerned by the misinformation being shared. However, it is also important to note that we are still in a ‘standstill period’, which imposes legal restrictions on the extent of information we are able to share at this time.

Procurement Process

Misconception: This is a cost-cutting exercise, and a new provider will not deliver a local GP Out of Hours Service.

This is inaccurate. The GP Out of Hours service specification has not been changed from what is currently provided by ShropDoc, the incumbent provider. All elements of the contract have been retained within the service specification, and there is no difference to what is currently being delivered.

Although, as NHS commissioners, we have a duty to ensure that public funds are spent wisely, this is not a cost-saving exercise. While cost accounted for 40% of the total evaluation, 60% focused on quality and innovation. All bidders for the contract were scored based on their ability to meet the specification requirements.

Important points for clarification:

1. The GP Out of Hours service specification remains the same as what is currently provided by ShropDoc.
2. The financial value of this procurement process remains consistent with the current services provided; meaning this does not represent a cut to funding.
3. The service will remain a local provision, delivered by local clinicians.

While we cannot share any details of the new service at present, the specification outlines the requirements of a local service for Shropshire, Telford and Wrekin. The importance of local knowledge and values were also emphasised in the service specification.

NHS STW is committed to ensuring local provision continues to be delivered by local clinicians, and that all current bases are utilised by the provider to enable this continuation. Within the specification, we have guaranteed that those bases currently commissioned will remain, and we are working with colleagues from the Powys Teaching Health Board on a mutually beneficial arrangement to ensure that cross-border access is maintained.

Misconception: The procurement of this service has been carried out unlawfully.

This is inaccurate. Our primary objective as NHS commissioners is to ensure the very best GP Out of Hours Service for our patients and residents. We also need to ensure the procurement process complies with national regulations, that the service is high-quality, value for money, and meets the needs of our local people.

Alongside our procurement colleagues. who are experts in procurement regulations, we have carried out a robust, transparent, fair and lawful process in order to identify the best provider for the GP Out of Hours Service in Shropshire, Telford and Wrekin.

Misconception: Some elements of the GP Out of Hours contract were added at a later stage.

This is not true. Both the Care Co-ordination Centre and the Single Point of Access (CCCSPA) were part of the published competitive process in October 2024, in accordance with national regulations.

Misconception: The GP Out of Hours Service is being stopped altogether.

This is incorrect. The service is crucial for both the local population and the health and care system in Shropshire, Telford and Wrekin to reduce demand on other services. The service will remain available to everyone, though it may be delivered by a different provider.

The procurement exercise has been undertaken to ensure provision of a high-quality, value for money service. Local residents should not see any negative effect on the service available to them and it will remain free for all.

Service Delivery

Misconception: There will be no face-to-face appointments available, only telephone consultations.

This is incorrect. As outlined in the service specification, face-to-face appointments form a core element of this service and will remain available both at the current out of hours bases and through home visits.

Within the specification we also describe the requirement of the provider to utilise the most appropriate base locations for service delivery, matching capacity against demand, and ensuring equal access to services. This included the need for multiple base locations given the geography of Shropshire, Telford and Wrekin, and the continuity of appointment availability in the five localities from which face-to-face appointments are currently offered.

Misconception: Services for Palliative and End of Life Care (PEoLC) will no longer be available via the GP Out of Hours Service.

This is not true. This is a key element of the GP Out of Hours Service, as described in the specification and it is vital that services continue to be available for this group of people.

For anyone wanting further information on the service specification please refer to section 2.3 Service Description starting on page 15.

Public Engagement

Misconception: A public consultation was not carried out for this procurement process.

As there is no substantive service change, formal consultation was not required for this procurement exercise. NHS STW undertook an engagement exercise over a three-week period, from 27 August to 17 September 2024, to understand the views and experiences of out of hours services, as well as on where improvements could be made.

This included an online focus group and an online survey (completed by 579 people), which was made available in different formats to ensure accessibility. The survey was distributed via more than 200 community groups and organisations across the county, including our 50 General Practices, and shared widely across local media.

It is important to note that an extended engagement period would not have resulted in the current contract staying the same. By not undertaking a procurement, NHS STW would have contravened the Provider Selection Regime (PSR) which we are legally bound by as commissioners.

The engagement report has been published on the NHS STW website and for further information please see question 5 of the Frequently Asked Questions document.

Misconception: The public has not been informed during the GP Out of Hours procurement process.

To keep residents informed, we have utilised numerous methods of communications and engagement at each important juncture of the process, in line with standard practices.

This has included the engagement exercise mentioned above, sharing findings from the survey and focus groups through an engagement report, publishing the service specification, and distributing press releases at key stages of the process (in August, October, and January). Additionally, a comprehensive FAQ document has been drafted and is regularly updated, available on the NHS STW website.

Each of these materials were distributed to our full distribution list which includes media representatives, elected officials, voluntary sector organisations, Healthwatch colleagues, Patient Participation Groups (PPGs), health and care partner colleagues, senior leaders, and General Practice. The survey was also included within our community engagement and outreach programme where colleagues attend local meetings and community events across the county.

Further Information

Further information on the procurement process has been published on the NHS STW website, alongside the engagement report which outlines the process undertaken: General Practice (GP) Out of Hours Service.

A Frequently Asked Questions (FAQ) document is also available for reference, providing answers to a range of queries related to this work: GP Out of Hours Service FAQs.