Carpal Tunnel Services for North East Essex Clinical Commissioning Group

Please note link to the original contract notice https://www.contractsfinder.service.gov.uk/Notice/24c06a31-b098-4925-9918-dd8151b76a5a NEE CCG wishes to establish a single community provider contract for the provision of Carpal Tunnel Services. This will be a Community Service provided under a separate community contract. The Provider will receive all NEE referrals into this community service and there will be a community fixed price tariff i.e. non PbR. Referrals will be made by NEE GP Practices, the community physiotherapy service and the Clinical Assessment Service. In line with the DOH Patient Choice Framework, as a community service is available, there will be no legal requirement for a patient to be offered a choice of provider. GP practices will make the initial assessment and provide the first stage of conservative treatment i.e. wrist brace (where deemed appropriate) in primary care. Practices that are clinically competent will also administer steroid injections as the second stage of conservative treatment where appropriate. Practices recorded by the CCG as not being able to administer injections will refer patients to this community service for one course of treatment only (unless exceptional circumstances such as surgery is not an option). Following receipt of an injection, patients will be discharged back to their GP. If the GP believes that the conservative treatment has not been effective following the prescribed period, the GP may make a separate referral for decompression. On a restricted basis, if a patient has been referred for an injection, but the service feels the patient should go straight to surgery, then this will be permitted without referral back to the GP. Where following assessment by this service, the patient is found to have more complex needs and requires referral to an acute provider, this Service will make the referral & offer a choice of provider. Where this service is unable to achieve an accurate diagnosis, it may refer to secondary care for an EMG test, if required or perform the EMG test independently if competent to do so, subject to a threshold on numbers. The Community Provider will be expected to keep diagnosis via EMG tests to a minimum. GPs will not have direct access to EMG tests from acute providers, in order to reduce costs. This pathway will be supported by a local protocol for GPs with restriction criteria concerning referrals. The CCG is seeking to commission a consistent, timely, high quality, flexible and accessible service to patients that will focus on patient outcomes.