1 CASE STUDY Community Services: District Nursing and other Clinical Services Background This is a service that has recently been taken over by a London based Mental Health Trust. It provides health care within the community, outside of Hospitals. The contract was awarded 5 years ago and is due out for tender in late 2015. There may be an option for the trust to renew the contract if they can demonstrate better performance to commissioners. In the past there has been no knowledge of the demand and the capacity of each team within the service. The spread of resources is based on historic customs, and not on activity levels. Contract performance is not good. This is a combination of breaching on some waiting list targets and overspending. The trust acknowl

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