Complex Termination of Pregnancy (CTOP) Services across the South East

This notice is placed as a Prior Information Notice (PIN) to inform the market of NHS Thames Valley (TV) Integrated Care Board (ICB), (the Commissioner's), intention to commission the provision of NHS Termination of Pregnancy centres for patients presenting with medical complexity and/or significant co-morbidities requiring NHS treatment, in line with the specified requirements, in the capacity of the Regional Network Lead Provider (Hub). For the remainder of this document this will be referred to as the: Complex Termination of Pregnancy (CTOP) service.

The Commissioner would like to understand the level of provider interest in delivering these services. The Hub will deliver specialist medical and surgical termination of pregnancy care up to 23 + 6 weeks' gestation.

The Hub will also host the regional Single Point of Access (SPOA) and Multidisciplinary Team (MDT), lead on regional training and governance across providers. (NHS and Independent Sector Providers (ISP) where there are interdependencies/interfaces with NHS services).

Alongside the coordination of the network of NHS providers across the South East to ensure equitable, safe, and high-quality CTOP care. The service specification can be found at https://www.england.nhs.uk/wp-content/uploads/2021/03/183... Please also see the CTOP Service Model document hosted within the e-procurement system (Atamis) for a full description of the anticipated CTOP service across the South East.

Providers who are interested in delivering these services are asked to express their interest and complete a market engagement questionnaire using the correspondence function within Atamis by no later than 17:00 on 26th June 2026. To access the CTOP Service Model document and express an interest, providers should follow the link to Atamis, search for the opportunity by clicking on 'View our Live Opportunities' from the home page, then complete the 'CTOP Services Market Engagement Questionnaire' available within the system.

Please note that you will need to be registered on Atamis, and then select the option to 'register an interest' under the project titled 'Complex Termination of Pregnancy (CTOP) Services across the South East (Mkt Eng)', project reference C447378 to gain full access to the CTOP Service Model document and the CTOP Services Market Engagement Questionnaire. Atamis link: https://atamis-1928.my.site.com/s/Welcome Providers are reminded that the information documents provided in Atamis are indicative draft versions only and subject to change.

Providers should not rely upon these documents when submitting any future bids, instead referring to the tender documentation released with the relevant tender opportunity. The contract will be for an initial duration of 5 years (60 months) with an optional extension of 2 years (2 x 12 months).

Training Funding: £128,000 per year 5 year total: £640,000 Network Funding: £64,000 per year 5 year total: £320,000 Final Total: £192,000 per year 5 year total: £960,000 Activity funding will be paid for retrospectively based on the data collected centrally by the SPOA. The Commissioner is of the view that the Transfer of Undertakings (Protection of Employment) (TUPE) Regulations 2006 do not apply.

This exercise is being carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioner. SCW is currently subject to restructuring, and the management of this exercise may therefore move to a successor at some point during the process.

Participants will be informed of any such change, and any administrative changes because of it. This notice is placed as a Prior Information Notice (PIN) to inform the market of NHS Thames Valley (TV) Integrated Care Board (ICB), (the Commissioner's), intention to commission the Complex Termination of Pregnancy (CTOP) service, in line with the specified requirements, in the capacity of the Regional Network Lead Provider (Hub) responsible for the delivery, coordination and clinical governance of CTOP pathways across the South East region.

The Commissioner would like to understand the level of provider interest in delivering these services. The service specification can be found at https://www.england.nhs.uk/wp-content/uploads/2021/03/183... Please also see the CTOP Service Model document hosted within Atamis for a full description of the anticipated CTOP service across the South East.

Providers who are interested in delivering these services are asked to express their interest and complete a market engagement questionnaire using the correspondence function within Atamis by no later than 17:00 on 26th June 2026. To access the CTOP Service Model document and express an interest, providers should follow the link to Atamis, search for the opportunity by clicking on 'View our Live Opportunities' from the home page, then complete the 'CTOP Services Market Engagement Questionnaire' available within the system.

Please note that you will need to be registered on Atamis, and then select the option to 'register an interest' under the project titled 'Complex Termination of Pregnancy (CTOP) Services across the South East (Mkt Eng)', project reference C447378 to gain full access to the CTOP Service Model document and the CTOP Services Market Engagement Questionnaire. Atamis link: https://atamis-1928.my.site.com/s/Welcome Providers are reminded that the information documents provided in Atamis are indicative draft versions only and subject to change.

Providers should not rely upon these documents when submitting any future bids, instead referring to the tender documentation released with the relevant tender opportunity. The procurement will establish one Regional Lead Centre (Hub) responsible for: • Hosting the Single Point of Access (SPOA) for all CTOP referrals in the South East. • Leading the Regional Multidisciplinary Team (MDT) to review, triage, and allocate cases across the network. • Delivering direct clinical care for patients requiring both medical and surgical terminations up to 23 + 6 weeks' gestation. • Providing clinical governance and quality oversight for all Network Member Providers (Spokes). • Leading the training, upskilling, and maintenance-of-skills programme for the regional CTOP workforce, in line with the national CTOP service specification. • Coordinating regional data collection, audit, outcome reporting, and shared learning to ensure consistent standards of care across the South East.

Background: The national Complex Termination of Pregnancy (CTOP) service was established following publication of the NHS England Service Specification (2021) to ensure that patients with significant co-morbidities or medical complications requiring termination of pregnancy receive care in appropriately equipped NHS hospitals with access to multidisciplinary teams, diagnostics, surgical facilities, critical care, and blood transfusion services. Currently, provision within the South East is variable.

While several NHS Trusts provide elements of the service, there is no formally commissioned or coordinated regional network. The absence of a lead centre and a standardised referral pathway has resulted in patients travelling long distances to receive care in other regions, and in inconsistent access to clinical expertise, workforce resilience, and quality oversight.

This procurement seeks to address those inequities by establishing a Regional CTOP Hub-and-Network model, ensuring that every patient in the South East region can access safe, timely, and locally coordinated care. Service Model Overview The Regional Lead Provider (Hub) will: • Operate as the central coordination point for all CTOP referrals via a Single Point of Access (SPOA). • Host the regional CTOP MDT, bringing together consultants in obstetrics, gynaecology, anaesthesia, fetal medicine, maternal medicine, nursing/midwifery, radiology, pathology, and bereavement support to agree appropriate care pathways for each case. • Deliver both medical and surgical CTOP procedures up to 23 + 6 weeks' gestation for eligible patients. • Support Network Member Providers in delivering CTOP services within lower gestational limits (e.g. up to 13 + 6 or 19 + 6 weeks), providing clinical advice, escalation pathways, and governance oversight. • Provide clinical and operational leadership for the South East CTOP Network, ensuring alignment with national standards and the NHS England CTOP specification. • Lead the regional training programme to build and sustain CTOP workforce capability across the network. • Undertake regional data collection, analysis, and submission to NHS England, including audit of outcomes, equity of access, and quality indicators.

The network model will be designed to ensure consistent governance, integrated clinical pathways, and robust quality assurance. The Hub will be responsible for convening network meetings, facilitating shared learning, maintaining the risk register, and reporting performance and compliance to commissioners.

Scope of Services: The procured service will include, but not be limited to: • Provision of specialist medical and surgical termination of pregnancy services up to 23 + 6 weeks. • Access to on-site or formalised arrangements for theatres, diagnostics, blood products, critical care, and other relevant specialities. • Delivery of pre-, peri-, and post-procedure care, including counselling, anaesthetic support, and bereavement care. • Implementation of robust clinical governance and audit processes across the network. • Participation in national reporting and assurance processes, including the Abortion Notification System and NHS Maternity Services Dataset. • Leadership of regional training and competency maintenance, in line with the national CTOP service specification. • Ensuring compliance with all relevant legislation, including the Abortion Act 1967, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Equality Act 2010, and NHS England's Health Inequalities Improvement Framework. Expected Outcomes: The procurement will ensure: • Equitable access to complex termination services across all South East ICB areas. • Reduction in patient travel outside of region for late-gestation or complex procedures. • Consistent standards of clinical governance and safety across all providers. • Development of a sustainable regional workforce with maintained surgical and medical CTOP skills. • Improved quality, data visibility, and outcomes monitoring through a coordinated network model.

Geographical Coverage: The procurement covers the South East Region, including the following NHS Integrated Care Board (ICB) areas: • Kent and Medway • Surrey and Sussex • Hampshire and Isle of Wight • Thames Valley The Hub will be expected to operate as a regional coordination centre, serving patients from across all four ICBs Contract and Procurement Details: The contracts will be for an initial duration of 5 years (60 months) with an optional extension of 2 years (2 x 12 months). The Commissioner is of the view that the Transfer of Undertakings (Protection of Employment) (TUPE) Regulations 2006 do not apply.

However, bidders must undertake their own independent assessment of TUPE applicability. This exercise is being carried out by NHS South, Central and West Commissioning Support Unit (SCW) on behalf of the Commissioner.

SCW is currently subject to restructuring, and the management of this exercise may therefore move to a successor at some point during the process. Participants will be informed of any such change, and any administrative changes because of it.