SEL ICB (Bexley) Primary Care Acute Respiratory Infection (ARI) Hub

Core service model

• Face-to-face, same-day urgent appointments for adults and children with ARI-type symptoms who meet the agreed referral and clinical inclusion criteria.
• Operation Monday to Friday, 08:00 to 18:30, from 1 December 2026 to 28 February 2027, subject to final contracting confirmation.
• Clinical staffing comprising of a GP and an Advanced Nurse Practitioner, with administrative support sufficient to manage bookings, referrals, communication and reporting.
• Referrals from Bexley GP practices and NHS 111, with approximately 10-15% of appointment capacity ringfenced for NHS 111.
• Clinical assessment, treatment, prescribing where appropriate, safety-netting, onward referral and communication back to the registered practice in accordance with agreed pathways.
• Directory of Services registration and maintenance of accurate service information to support NHS 111 referral, subject to commissioner confirmation for 2026/27.
• Compliance with applicable information governance, infection prevention and control, safeguarding, medicines management, workforce, premises, business continuity, incident reporting and clinical governance requirements.

Commissioner requirements and controls

Access and referral

• The provider must operate a clear, documented referral and triage pathway, including acceptance, rejection, redirection and escalation arrangements.
• The provider must make referral criteria, operating hours, contact arrangements and any capacity constraints available to all referring services before mobilisation.
• The provider must operate a booking arrangement that enables authorised staff in Bexley GP practices to view and directly book patients into available same-day ARI Hub appointments, in accordance with the agreed clinical inclusion and exclusion criteria. The booking process must be straightforward, reliable and supported by clear referral guidance and escalation arrangements.
• The provider must work with Bexley GP practices, NHS 111 and the Commissioner to manage appointment capacity fairly and efficiently. Capacity should be made available across general practice with regard to registered list size and anticipated demand, while maintaining the agreed allocation for NHS 111. Where up-take by a practice or referral route is lower than expected, unused capacity must be released or reallocated promptly through an agreed process so that appointment slots remain available to other Bexley practices and avoidable unused capacity is minimised.
• The provider must have arrangements for interpreting, accessible communication and reasonable adjustments.

Clinical quality and safety

• The provider must maintain a named clinical lead and clear clinical accountability for the service.
• All clinicians must be appropriately registered, qualified, trained, competent and indemnified for the work undertaken. GPs must meet applicable performers list requirements.
• The provider must have agreed pathways for deteriorating or clinically unstable patients, emergency transfer, safeguarding, paediatric escalation and onward referral.
• The provider must maintain appropriate prescribing, medicines reconciliation and antimicrobial stewardship arrangements.
• The provider must record each consultation contemporaneously and ensure relevant information is communicated promptly to the patient's registered practice.
• The provider must report patient safety incidents, serious incidents, safeguarding concerns, complaints and service disruption in accordance with the contract and ICB requirements.

Workforce, premises and mobilisation

• The provider must demonstrate a deliverable workforce plan, including rota resilience, sickness cover, clinical supervision and arrangements for periods of peak demand.
• The provider must be able to mobilise the service within the required timescale from a centrally located Bexley primary care site that is reasonably accessible to patients referred by all Bexley practices. The provider must demonstrate that the proposed location supports equitable borough-wide access, including by public transport, and is clinically suitable, compliant with infection prevention and control requirements and appropriately equipped for urgent face-to-face care for adults and children.
• The provider must have digital and telephony arrangements capable of receiving referrals, booking appointments, accessing or recording relevant clinical information and sharing information securely.
• The provider must complete mobilisation activity before 1 December 2026, including workforce checks, pathway sign-off, NHS 111 / DoS arrangements, communications, premises assurance, clinical governance and business continuity testing.

Performance management and reporting

The provider will be required to submit timely, complete and accurate activity, quality, workforce, finance and patient experience information in a format and frequency agreed by the ICB. As a minimum, commissioner reporting should cover:

• appointments offered, booked, attended, cancelled, unused and not attended
• referral source, including Bexley general practice and NHS 111
• patient age group and other agreed demographic and geographic fields required to assess access and inequalities
• presenting condition / ARI category and consultation outcome
• prescribing, onward referral, conveyance or transfer to urgent / emergency or secondary care, where captured
• capacity utilisation, staffing fill, service disruption and business continuity events
• complaints, patient feedback, incidents, safeguarding concerns and learning actions

The provider must monitor service activity, access, utilisation, quality and outcomes throughout the contract period and submit agreed performance information to the ICB within the required timescales. The provider must also provide regular, proportionate performance updates to Bexley practices, including information on available capacity, utilisation, referral patterns and any operational issues requiring …