Individual Placement Contract

Location

London

Description

The person is a young adult with a diagnosis of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anorexia nervosa, and complex developmental trauma. The person has been an inpatient for over three years and has been subject to long-term segregation for more than two years due to the level of assessed risk and complexity of needs. The person turned 18 in July 2025.

Total Quantity or Scope

The person is a young adult with a diagnosis of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), anorexia nervosa, and complex developmental trauma. The person has been an inpatient for over three years and has been subject to long-term segregation for more than two years due to the level of assessed risk and complexity of needs. The person turned 18 in July 2025. The person has been clinically assessed and accepted by Ellern Mede Hospital in Sheffield, a specialist provider with expertise in managing complex eating disorders alongside autism, neurodevelopmental conditions, and significant trauma histories. The person continues to present with significant risks, which are currently managed through enhanced nursing observations at a 5:1 ratio (3:1 constant observations with additional staff on rotation), alongside care in a highly controlled environment free from potential risk items. A gradual and carefully managed approach to peer interaction and external exposure is required due to the person's vulnerability and risk profile. Due to the ongoing requirement for nasogastric (NG) feeding under restraint, combined with serious mental health risks including high suicide risk, the person requires treatment within a specialist adult mental health inpatient setting with the appropriate clinical expertise, staffing levels, and governance arrangements to safely manage these needs. The person remains detained under Section 3 of the Mental Health Act and therefore requires ongoing treatment within a hospital setting. The complexity of the person's presentation, including the interaction between anorexia nervosa, autism, ADHD, OCD, and trauma, necessitates intensive multidisciplinary team (MDT) input that cannot be safely or effectively delivered in a non-specialist or community setting at this time. The clinical team at Ellern Mede Hospital recommend that continued inpatient admission remains clinically necessary, and that Ellern Mede is an appropriate placement to meet the person's complex clinical needs. Funding approval is therefore essential to enable transfer to this specialist setting and to prevent further deterioration in the person's mental and physical health, reduce ongoing risk, and support recovery

Award Detail

Award Criteria

CPV Codes

• 85111500 - Psychiatric hospital services

Indicators

• Award on basis of price and quality.

Legal Justification

This contract has been awarded under the urgent circumstances provision of the Provider Selection Regime (PSR). It is awarded in accordance with the Health Care Services (Provider Selection Regime) Regulations 2023. For the avoidance of doubt, the provisions of the Procurement Act 2023 do not apply to this award. The award has been made under Regulation 14 due to urgent clinical need: the patient requires an urgent change of care provider as the current provider has been clinically unsuitable to ensure a safe and sustainable discharge. A competitive process was not feasible without compromising patient and public safety. The selected provider, ELLERN MEDE, was immediately available with the capacity to deliver the highly specialised care required. The contract will be reviewed every three months, with a view to with the view to complete the programme in 12months if safe to do so. The request was presented to our internal health panel, and the panel agreed with the proposed package and costs. No conflicts of interest were declared by any individual involved in the decision-making process. A conflict of interest check was completed and recorded, and no actual or perceived conflicts required mitigation.

Other Information

Daily Breakdown: OBD: £2,400 per day Breakdown of Daily Costs: • OBD (Daily): £2,400 per day • Nursing (Daily): £960 per day (1 nurse x £40 x 24 hours) • HCA (Daily): £2,400 per day (4 HCAs x £25 per staff (4) x 24 hours ) Monthly Estimate: Assuming 30 days in a month: OBD (Monthly): • £2,400 per day x 30 days = £72,000 Nursing (Monthly): • £960 per day x 30 days = £28,800 HCA (Monthly): • £2,400 per day x 30 days = £72,000 Total Monthly Estimate for OBD and Staffing: • OBD: £72,000 • Nursing: £28,800 • HCA: £72,000 Total Monthly Estimate: £172,800 Annual estimate: £2,073,600