STANDARD
NHS CONTRACTS
Carole Hodgkinson
Head of Contracts
CISSU
Supporting Cheshire and Merseyside PCTs
WHY DO YOU NEED TO KNOW
ABOUT THE CONTRACT?
• Background
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Aims and Principals
National Contract
What is the Contract?
• Link to World Class Commissioning
• Key Elements
• Where do you fit in?
Supporting Cheshire and Merseyside PCTs
HOW DOES THE CONTRACT APPLY
TO YOU ?
Supporting Cheshire and Merseyside PCTs
• How can I use the contract to
improve healthcare?
• How can the contract help me
deliver my organisation’s objectives?
• How do I fit into the process?
Supporting Cheshire and Merseyside PCTs
BACKGROUND
4 STANDARD NHS CONTRACTS
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Acute
Community
Mental Health
Ambulance
Supporting Cheshire and Merseyside PCTs
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WHY?
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WHEN?
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HOW?
Supporting Cheshire and Merseyside PCTs
NATIONAL
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Guiding Principles
Behaviours
Economics
Targets to rights
Supporting Cheshire and Merseyside PCTs
GUIDING PRINCIPLES
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Reflect vision, long term planning and change
Recognise the community interest
Provide clarity on commitments that need to be
made to stakeholders
Clarify and define respective roles and
responsibilities
Recognise that open information is required to
manage the contract
Underpin a relationship between equals
Understand mutual dependency and benefit of
the parties in aiming for a partnership approach
Supporting Cheshire and Merseyside PCTs
GUIDING PRINCIPLES (cont’d)
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Support co-operation and collaborative
behaviours that benefit all parties and
cement the positive relationship between
them
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Be based on terms that are deliverable in
practice
Supporting Cheshire and Merseyside PCTs
EXPECTED BEHAVIOURS
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Find and support win-win solutions
Achieve appropriate risk sharing and
sharing of any benefits that are realised by
mutual effort
Maintain mature, regular dialogue within a
professional code of conduct
Ensure flexibility where there are genuine
problems in delivery
Supporting Cheshire and Merseyside PCTs
EXPECTED BEHAVIOURS (cont’d)
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Provide incentives as well as penalties
Recognise investment required to achieve
requirements over a reasonable time period
Support providers to change their service
officer over time in relation to changes
brought about through patient choices
Maintain honesty and transparency – across
both parties and with patients and the public
Supporting Cheshire and Merseyside PCTs
WHAT IS THE CONTRACT?
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Covers all agreement for services
between PCTs, L.A and service
providers
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Is a ‘standard’ not a model
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Supports achievement of key
standards and targets
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Legally binding
Supporting Cheshire and Merseyside PCTs
WHAT IS THE CONTRACT? (cont’d)
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Within principles and rules for co-operation
and completion
Goal to achieve genuine agreement about
services & payment
Should support and encourage providers to
innovate and improve services and patient
experience.
Supporting Cheshire and Merseyside PCTs
WHY IS THE CONTRACT
IMPORTANT
WORLD CLASS COMMISSIONING
COMPETENCIES
Stimulate
the market
Secure
Procurement
Skills
Supporting Cheshire and Merseyside PCTs
Manage
the local
Health System
KEY ELEMENTS (1)
Structure
• Elements which are mandatory
(Red)
• Elements which must be identified
but the details is for local agreement (Amber)
• Additional elements added locally
(Green)
• Community Modular
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (2)
PARTIES TO THE CONTRACT
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Co-ordinating Commission
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Associate Commission
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Partnership Arrangements
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Supporting Cheshire and Merseyside PCTs
Consortium
Agreements
KEY ELEMENTS (3)
CONTRACT CONTROLS & LEVERS
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18 weeks
HCAI
Excess Activity
Nationally Specified Events
CQUIN
Supporting Cheshire and Merseyside PCTs
CONTRACTS LEVERS
The roles of the different contract
levers:
Option local incentive
Stretching goals where achievement
Results in incentive payments
CQUIN
Service Specification &
Quality Schedule
CQC Requirements
Baseline targets where there are
consequence for non-achievement
Requirements for
Non-regulated services
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (4)
Managing Activity & Referrals
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Shared Responsibility
Activity Managements Plans
Prior Approval and PLCPs
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (5)
Service Specification
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (6)
Quality Including Patient Experience
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Key quality requirements
Monthly quality monitoring
CQUIN (1.5%)
Never events
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (7)
Price and Volume
Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (8)
Information
Supporting Cheshire and Merseyside PCTs
OTHER ELEMENTS
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Service Development and
Improvement Plan
Disputes
Safeguarding
Impact Assessment
SUI
Networks
DSSA
Supporting Cheshire and Merseyside PCTs
MONITORING
Monthly/Quarterly Performance and
Quality Reviews
Supporting Cheshire and Merseyside PCTs
All the contracts and their guidance can be
found at
http://www.dh.gov.uk/en/Publications/managingyourorganisation/
commissioning/systemmanagement/DH_085048
Supporting Cheshire and Merseyside PCTs
WHERE DO YOU FIT IN?
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Care Pathways
Prior Approval
Service Specifications
Demand Management
Treatment Protocols
Performance and Incentiveness
Quality Standards
Health Impact Assessment
Procurement
Supporting Cheshire and Merseyside PCTs
THANK YOU
ANY QUESTIONS?
Supporting Cheshire and Merseyside PCTs
Supporting Cheshire and Merseyside PCTs
Supporting Cheshire and Merseyside PCTs