II.2.2) Cod(au) CPV ychwanegol
85323000
II.2.3) Man cyflawni
Cod NUTS:
UKE
Prif safle neu fan cyflawni:
The service must operate as two locality-based teams:
• Team A: Hambleton, Harrogate & Richmondshire
• Team B: York & Scarborough
II.2.4) Disgrifiad o’r caffaeliad
Service Specification
Adult Eating Disorder Alternative to Hospital Admission (AL2A) and FREED Service
North Yorkshire and York (NYY)
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1. Purpose of the Specification
The Humber and North Yorkshire Specialist Mental Health Provider Collaborative (the commissioner), seeks to procure an Adult Eating Disorder Alternative to Hospital Admission (AL2A) service, inclusive of First Episode Rapid Early Intervention for Eating Disorders (FREED).
The service will provide intensive, time-limited, community-based interventions as an alternative to inpatient admission, and as step-down support following admission, in order to:
• Reduce avoidable admissions
• Reduce length of inpatient stay
• Improve patient experience and outcomes
• Reduce out-of-area placements
• Deliver value for money through invest-to-save approaches
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2. Service Objectives
The Provider shall deliver a service that achieves the following objectives:
1. Reduce the number and duration of adult eating disorder inpatient admissions (including out-of-area placements)
2. Provide safe, effective, intensive community-based care for adults at high risk of admission
3. Support earlier discharge from inpatient care through structured step-down support
4. Reduce the need for restrictive interventions, including naso-gastric (NG) feeding
5. Improve equity of access to eating disorder services across North Yorkshire and York
6. Deliver early intervention through the FREED model to prevent illness escalation
7. Improve patient-reported outcomes, experience, and family/carer involvement
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3. Scope of Service
3.1 Eligible Population
The service shall support:
• Adults (18+) with a diagnosed eating disorder
• Individuals at high risk of admission to an acute or specialist eating disorder inpatient service
• Individuals requiring step-down or early supported discharge from inpatient care
• Individuals where intensive community support may prevent deterioration, including risk of NG feeding
• Young adults aged 18-25 eligible for FREED where commissioned and clinically appropriate
3.2 Exclusions
• Crisis response or 24/7 home treatment provision
• Emergency medical care (to be delivered via existing acute pathways)
• People who do not have a diagnosed eating disorder
• People aged under 18
• People not registered with a GP within North Yorkshire and York and/or People who do not live within North Yorkshire and York
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4. Service Model Requirements
4.1 Core Model
The Provider must deliver:
• Intensive, time-limited intervention of up to 12 weeks
• A stepped-care approach supporting both admission avoidance and early discharge
• Integration within existing community adult eating disorder MDTs
• Close working with inpatient services, acute hospitals, crisis teams, and community mental health teams
4.2 Geographic Delivery Model
The service must operate as two locality-based teams:
• Team A: Hambleton, Harrogate & Richmondshire
• Team B: York & Scarborough
Provision must be flexible to meet rural and urban population needs, including travel, virtual delivery, and outreach.
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5. Interventions to Be Delivered
The Provider shall deliver, as a minimum:
5.1 AL2A Interventions
• Supported eating (1:1 and group, face-to-face and virtual)
• Meal planning, shopping, cooking, and eating-out support
• Daily living skills development
• Family and carer coaching and supported meal guidance
• Development of recovery-focused support plans
• Exposure-based and skills-based interventions
• Social inclusion, occupational engagement, and signposting (e.g. employment, education, social prescribing)
• In-reach to acute hospitals, including daily support when admitted
• Contribution to bed management and admission decision-making processes
5.2 FREED Pathway
The Provider shall deliver the FREED model in line with national evidence, including:
• Initial screening contact within 48 hours of referral
• Assessment within 2 weeks
• Treatment commencement within 4 weeks
• Highly coordinated, early-intervention care aimed at reducing duration of untreated illness
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6. Workforce Requirements
The Provider must evidence a workforce model consistent with:
• Clearly identified clinical leadership and governance
• Competence in delivering evidence based interventions for eating disorders, including the assessment and treatment of complex eating disorder presentations with co morbid physical and mental health conditions.
• Capacity to work flexibly across home, community, and virtual settings
• Cultural competence to address health inequalities
Indicative staffing expectations include:
• A Multi-Disciplinary Team with relevant professional registration trained in working with people with a diagnosed eating disorder
• Support staff trained in eating disorder care
• FREED workers with appropriate specialist experience
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7. Interfaces and Dependencies
The Provider must demonstrate robust arrangements for:
• Integration with community adult eating disorder teams
• Joint working with inpatient eating disorder services
• Participation in provider collaborative bed management meetings
• Liaison with acute trusts, crisis services, and community mental health teams
• Alignment with mental health hubs and neighbourhood teams
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8. Key Performance Indicators (KPIs)
8.1 Activity and Access
KPI Measure
AL2A caseload Number of individuals supported per quarter
Time to AL2A intervention ≤5 working days from referral
FREED screening ≥95% within 48 hours
FREED assessment ≥95% within 14 days
FREED treatment start ≥90% within 28 days
8.2 Impact and Outcomes
KPI Measure
Admission avoidance % of AL2A episodes avoiding inpatient admission
Length of stay Reduction in average inpatient LoS for stepped-down patients
OOA placements Reduction compared to baseline year
NG feeding Reduction in proportion requiring NG feeding
Readmission 30- and 90-day readmission rates
8.3 Experience and Quality
KPI Measure
Patient-reported outcome measures (PROMs) Improvement between entry and discharge
Patient experience ≥85% positive feedback
Family/carer satisfaction ≥80% positive feedback
Complaints Trend monitored and minimised
8.4 Equity and Safety
• Monitoring of access and outcomes by geography, age, gender, and deprivation
• Incident reporting and learning
• Safeguarding compliance
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9. Reporting and Governance
The Provider shall:
• Submit quarterly KPI and quality reports
• Participate in:
o Quality and Contract Review Meetings (quarterly)
o Quality Assurance & Improvement Groups (bi-monthly)
o Risk register reviews
o Six-monthly and annual quality visits
• Contribute to collaborative benchmarking and BI datasets
• Support a formal evaluation against agreed baseline metrics
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10. Mobilisation Requirements
The Provider must submit a mobilisation plan including:
• Recruitment timelines
• Workforce training strategy
• Referral and pathway readiness
• Stakeholder engagement
• Go-live readiness and risk mitigation
11. Contract Duration
The initial contract term will be 18 months with an option for the Commissioner to extend contract up to two further years.