CPH138 - Clinical Assessment and Prescribing Service for Varenicline, Bupropion and Cytisinicline (also known as Cytisine)

The direct award is justified under Section 41 of the Procurement Act 2023 and Schedule 5, Paragraphs 13 and 14 (Urgency). The paragraph 13 justification allows a direct award where:

The good, services or works to be supplied under the public contract are strictly necessary for reasons of extreme and unavoidable urgency, and

as a result the public contract cannot be awarded on the basis of a competitive tendering procedure.

Paragraph 14 provides that urgency is unavoidable if it is not attributable to any act or omission of, and could not have been foreseen by, the Council.

The need for this arrangement has arisen following the unforeseen withdrawal of Derbyshire GP practices from providing prescribing services for prescription only medications for stop smoking. GP practices have advised that they are no longer willing to undertake this activity due to concerns regarding reimbursement for clinical time, administration, prescribing activity and patient management. This decision was outside of the Council's control and was not attributable to any act or omission of the Council. The Council had previously relied on GP practices to undertake this element of the service and could not reasonably have anticipated a widespread withdrawal of provision across the county.

The withdrawal of GP prescribing support creates an immediate risk to the continuity of Derbyshire's Stop Smoking Service. Without an alternative prescribing provider, residents requiring clinically appropriate smoking cessation medications would be unable to access an essential component of the treatment pathway. Varenicline, Cytisine and Bupropion are all recommended for use for smoking cessation by the National Institute for Health and Care Excellence. This would result in disruption to service delivery, reduced smoking cessation outcomes and potential adverse impacts on public health. At present around one in five people who use the Derbyshire Stop Smoking service use prescription only medications to help them quit smoking (circa 800 people in 2025/26).

Council intends to undertake a full and compliant competitive procurement process for the longer-term provision of this service.

The proposed direct award is therefore a temporary and proportionate interim measure to maintain continuity of service whilst the procurement exercise is undertaken and any resulting contract is implemented.