Proposed decision:
To award 6-month extensions to contracts for the provision of Post-Mortem (PM) facilities to Dartford and Gravesham NHS Trust, East Kent Hospitals Trust and Medway NHS Trust and confirm current arrangements.
Background and reason for the decision:
The Coroners and Justice Act 2009 places a duty on Coroners to investigate deaths that are referred to them if they have reason to think that:
§ The death was violent or unnatural;
§ The cause of death is unknown; or
§ The deceased died while in prison, police custody or another form of state detention
In some cases, the Coroner will order a post mortem (PM) to establish the cause of death, and in such cases, the deceased is taken to one of five NHS mortuaries across Kent and Medway located at Margate, Ashford, Tunbridge Wells, Dartford, and Gillingham.
On behalf of the Kent and Medway Senior Coroners, KCC ensures access to body storage and PM facilities across the four Kent coroner areas. KCC does not have its own public mortuary facility and so like many other coroner areas across England and Wales it relies on local NHS hospitals which have the necessary facilities for this purpose; there are no private sector providers of PM facilities anywhere in England and Wales.
The contract extensions were initially entered into in 2021, with the details and intentions set out in planned decisions 21/00079 and 21/00096 (covering Mid Kent & Medway, North East Kent and Central & South East Kent coroner areas). It is now necessary to review, collate and update the relevant contracting and governance associated with these arrangements and to seek to extend the contracts by a further 6 months until the end of March 2023 via a single co-ordinated decision. The planned approach will address the outstanding governance and time gap involved with the prior decisions while also supporting ongoing provision – therefore this decision confirms the required arrangements undertaken for the previous year and allows for appropriate service continuation prior to new contracts being put in place (via separate relevant decision-making) for April 2023 onwards.
This six-month period will be used by the Coroner Service to better understand the service and associated costs of running the contract for the Trusts. Contract terms will be updated and developed using these findings and in line with KCC’s future needs, including the implementation of the Digital Autopsy (DA) service. Currently it is unclear how the DA project will be progressing; therefore a 6-month contract extension will allow more time for KCC to determine DA’s direction of travel and develop a contractual arrangement that complements the DA service once it goes live.
Options considered and discarded:
Option 1: Do nothing
This is the current situation as the service is operating outside of a contract. Unless a contract is put in place, the Council is at risk of receiving an inconsistent provision and quality of service, a lack of control over costs, and subsequent reputational ramifications.
Option 2: Go out to tender
Kent NHS Trusts do not have capacity to take on any extra work without significant capital investment, and past use of mortuaries outside Kent have not delivered a suitable service.
Option 3: Use a framework or other viable contract mechanism
There are no known frameworks or other viable mechanisms for the provision of mortuary facilities in England and Wales.
Option 4: Extend the contracts for a longer period until the DA facility opens
Extending the contracts for 12-18 months will not provide KCC with the flexibility to negotiate new contracts for mortuary services that support the DA facility.
How the proposed decision supports Framing Kent’s Future 2022-2026:
Data Protection implications:
A Data Protection Impact Assessment screening form has been completed, which concludes that a DPIA is not required.
Decision type: Key
Reason Key: Affects more than two Electoral Divisions;
Decision status: Recommendations Approved
Notice of proposed decision first published: 15/11/2022
Anticipated restriction: Part exempt - View reasons
Decision due: Not before 14th Dec 2022 by Cabinet Member for Community and Regulatory Services
Lead member: Cabinet Member for Community and Regulatory Services
Lead director: Stephanie Holt-Castle
Department: Growth, Environment & Transport
Consultees
The proposed decision will be discussed at the Growth, Economic Development and Communities Cabinet Committee on 22 November 2022.
Financial implications: Unless a contract extension is put in place, the NHS Trusts can charge as much as they want for the provision of mortuary services. The contract with East Kent NHS Trust is a fixed fee regardless of activity levels and will be paid in 6 equal instalments. The other two contracts with Dartford and Gravesham and Medway NHS Trusts are charged on a cost per PM basis. The estimated total cost of the contract extensions is within the budgeted revenue cost for 2022-23.
Legal implications: This tendering opportunity has not been subject to competition. The existing contract can be extended, as supported by Regulation 72 (c) (ii) and (iii) of the Public Contract Regulations which states that a contract may be modified without a new procurement procedure in accordance (c) (ii) the modification does not alter the overall nature of the contract; (iii) any increase in price does not exceed 50% of the value of the original contracts or framework agreement.
Equalities implications: The Equalities Impact Assessment (EqIA) completed in 2019 for this service was reviewed last year when contract extensions were awarded to the three NHS Trusts. Nothing has changed since then, and no issues have been identified by the service.