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STANDARD NHS CONTRACTS Carole Hodgkinson Head of Contracts CISSU. WHY DO YOU NEED TO KNOW ABOUT THE CONTRACT?. Background Aims and Principals National Contract What is the Contract ? Link to World Class Commissioning Key Elements
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STANDARDNHS CONTRACTSCarole HodgkinsonHead of ContractsCISSU Supporting Cheshire and Merseyside PCTs
WHY DO YOU NEED TO KNOW ABOUT THE CONTRACT? • Background • 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 • Acute • Community • Mental Health • Ambulance Supporting Cheshire and Merseyside PCTs
WHY? • WHEN? • HOW? Supporting Cheshire and Merseyside PCTs
NATIONAL • Guiding Principles • Behaviours • Economics • Targets to rights Supporting Cheshire and Merseyside PCTs
GUIDING PRINCIPLES • 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) • Support co-operation and collaborative behaviours that benefit all parties and cement the positive relationship between them • Be based on terms that are deliverable in practice Supporting Cheshire and Merseyside PCTs
EXPECTED BEHAVIOURS • 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
EXPECTEDBEHAVIOURS (cont’d) • 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? • Covers all agreement for services between PCTs, L.A and service providers • Is a ‘standard’ not a model • Supports achievement of key standards and targets • Legally binding Supporting Cheshire and Merseyside PCTs
WHAT IS THE CONTRACT? (cont’d) • 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 Manage the local Health System Supporting Cheshire and Merseyside PCTs
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 • Co-ordinating Commission } Consortium • Associate Commission } Agreements • Partnership Arrangements } Supporting Cheshire and Merseyside PCTs
KEY ELEMENTS (3) CONTRACT CONTROLS & LEVERS • 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 • 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 • 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 • 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? • 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