Issue details

Proposed Decision:

To award an annual contract that can be renewed/extended up to two times, for provision of Post-Mortem (PM) facilities to the Dartford and Gravesham NHS Trust, East Kent Hospitals University Foundation Trust, Maidstone and Tunbridge Wells NHS Trust and Medway NHS Foundation Trust.

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, for example, where a Deprivation of Liberty Safeguard Order (DoLS) is in place.

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 a pre-designated mortuary for this purpose. On behalf of the Kent 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.

All four of the contracts for body storage and PM facilities for the four Kent coroner areas expire on 31 March 2023 and it is necessary to put in place new contracts to secure this critical service, at which point new contracts can be awarded. Contract terms have been updated and developed using our findings and in line with KCC’s future needs, including the implementation of the Digital Autopsy (DA) service. An annual contract that can be renewed/extended 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 (other options considered but discarded):

Option 1: Do nothing

This is a statutory service, and unless contracts are put in place the system of coronial death investigation and certification in the Northwest Kent, Northeast Kent and Central & Southeast Kent coroner areas will fail. The Council will also be 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 Competitive Tender Process

There are no private sector organisations within this marketplace locally, and previous experience of mortuary use outside of Kent has not delivered a suitable service. A competitive tender process will not yield a competitive process.

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: One NHS Trust delivers all PMs

No single facility can accommodate the number/level of PMs.

Option 5: Renew contract through single source procurement Direct award new contracts to the NHS Trusts

Direct award new contracts to the NHS trusts through the regulation 12 exclusion permitted within PCR15. This option is recommended given the very specialist nature of the work and the absence of any alternative providers with sufficient capacity in Kent or nearby adjoining areas.

-       How the proposed decision supports Framing Kent’s Future 2022-2026: (https://www.kent.gov.uk/about-the-council/strategies-and-policies/corporate-policies/our-council-strategy)

The proposed Digital Autopsy facility, to which these contracts are directly linked, supports Priority 2: Infrastructure for Communities via a further digitalisation of KCC’s service offer, and finding better ways to deliver services for Kent. This short-term flexible contract allows for DA to come in midway through the contract period.

Financial Implications:

Unless contract renewals are put in place, the NHS Trusts can charge as much as they want for the provision of mortuary services. The new contracts will provide service continuity and cost certainty in times of current double digit inflation uplifts if no contract were in place.

The contract with East Kent NHS Trust is a fixed fee regardless of activity levels and is paid in 6 equal instalments, however the discussions for the new contract will include payment based on activity levels. The contracts with the other NHS Trusts are charged on a cost per PM basis.

In 22/23, including capital and revenue across the whole project or the full lifetime of the contracts, the total cost was £1,350,635.75, 23/24 is still pending negotiation.

The Coroners service cover Kent and Medway and Medway are charged an element of all costs based on population numbers.  Currently they are charged approx. 15% of all Coroner costs.

Arrangements are in place with the NHS Trust Mortuary Services to make provisions for the temporary and longer-term storage of the deceased while under the jurisdiction of the Kent and Medway coroners. This will include the provision of refrigerated and deep freeze storage. The Trusts will make suitable provisions for alternative storage of the deceased should fridge or freezers be dysfunctional, or capacity is exceeded during exceptional circumstances.

Pending negotiations, the new contracts will also give us the option of terminating after 12 months with a notice period of 6 months.

Data Protection Implications:

A Data Protection Impact Assessment screening form has been completed, which concludes that a DPIA is not required.