Overview and Scrutiny Committee Briefing Paper
Item 4
February 2008
This paper is to bring you up to date with all the latest developments of the Independent
Sector Clinical Assessment and Treatment Services (CATS) procurement for Greater
Manchester PCTs.
1
1.1
Introduction:
CATS are a new service model providing a more specialised level of clinical
assessment and treatment than is typically available in primary care. NHS
organisations across Greater Manchester have developed a range of Tier 2
services which provide specialist clinical assessment; CATS can be regarded as
taking this model further by having a greater range of diagnostic modalities and
offering treatments in an outpatient setting. Wherever possible CATS will utilise
a one-stop approach and have short waiting times. CATS will be crucial to the
successful delivery of referral to treatment patient pathways within the 18 week
target.
1.2
Greater Manchester PCTs, the Department of Health and the Independent Sector
(IS) have been working together on the procurement of an IS CATS for several
years. Commercial close was reached between the DH and Care UK on 14th
December 2007 and service commencement agreed, planned for the end of
September 2008. Financial close is still under negotiation.
2
2.1
CATs Service Overview:
Key features of the services being commissioned from Care UK are:
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CATS service for the following specialties: Musculoskeletal (i.e. Trauma &
Orthopaedics and Rheumatology), General Surgery, ENT, Gynaecology,
Urology
CATS episode to take a maximum of 4 weeks
Mobile solution consisting of up to 9 interlocking units. (Once inside patients
will feel as though they are in a medium sized health centre, rooms are
similarly sized to local outpatient departments, waiting areas are available)
7 sites across Greater Manchester - Salford site likely to be the car park of
Cousins Furniture Store on Regent Road. Sites in Bolton and Trafford also
accessible to some Salford patients
Service likely to be at any one site for two or three days per fortnight
Evening and weekend clinics will be available
24 hour designated telephone helpline
Care UK will not ‘poach’ NHS staff and will contribute to training programmes
through medical deanery, schools of nursing.
Clinical service to be in line with agreed patient pathways and is for adults
only
Range of treatments available as part of CATS episode e.g. medication, joint
injections, endoscopy
Care UK to provide pre-operative assessment for patients for whom it is
determined will require surgery in secondary care. Choice of secondary care
provider to be offered following CATS episode
Care UK can provide physiotherapy and occupational therapy if agreed by
referrer, following CATS episode
For further information contact Harry Golby on harry.golby@salford-pct.nhs.uk
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Care UK to also offer range of direct access diagnostics e.g. MRI, CT, nonobstetric ultrasound, echo cardiology, histology, pathology, etc.
3
3.1
Patient Choice:
The original concept was of a mandated pathway (i.e. to be the only option
available for GP referrals.) As the Free Choice policy has developed this concept
has had to be adapted and now CATS will be one of a range of options for
patients and referrers. This resulted in significant changes in PCT’s projections
of the numbers of referrals to the service.
3.2
Patients will have an opportunity to have a choice of hospitals if, following the
CATS episode, secondary care treatment is deemed necessary.
4
4.1
Numbers:
Greater Manchester PCTs submitted revised projected numbers of referrals in
August 2007. The total number of anticipated referrals into CATS is 9,930. This
is less than 10% of current referrals into secondary care.
5
5.1
Mobilisation:
Clinical - Care UK is responsible for the production of various policies e.g.
clinical leadership, clinical governance, medicines management, infection control,
etc. The NHS will be consulted and involved in sign-off processes.
5.2
Referrals management - the NHS is responsible for developing and agreeing
generic and condition-specific referral pathways and the administrative processes
underpinning them. High level pathways and processes have already been
discussed and agreed across Greater Manchester. This relates to referrals into
CATS (from GPs) and out of CATS (into Acute Trusts)
5.3
Workforce & training - Care UK are responsible for delivery of a workforce plan
to underpin the service. The NHS will be consulted, especially managing the
impact on the NHS workforce.
5.4
Sites - Sites can be changed or added to over the term of the contract if there is
a healthcare need identified by the PCT, or patients wanting to travel to either
different locations within the geographical boundary of the relevant PCT, or there
is an increase in utilisation of the services on offer and additional sites are
needed.
5.5
Diagnostics - GPs can have direct access to diagnostics and treatment capacity
as an extra to the contract where there is available spare capacity rather than just
refer a patient to the whole CATS pathway.
5.6
Information management and technology - Care UK are responsible for the
development of their IM&T systems. The NHS will be involved in sign off of
policy documents, in testing systems and interface with local systems. A Greater
Manchester group has been working on this but NHS attendance has been poor.
5.7
Communications and marketing - Care UK is responsible for the development
of an overall marketing plan. PCTs will be involved in signing-off this plan and on
agreeing local marketing with GPs.
For further information contact Harry Golby on harry.golby@salford-pct.nhs.uk