2020/21 NHS Standard Contract

2020/21 NHS Standard Contract
NHS England 10 March 2020

• The NHS Standard Contract for use by commissioners for all contracts for healthcare services other than primary care has been updated for 2020/21

Implementation toolkit for NHS Standard contract

2017-19 NHS Standard Contract provisions across primary and secondary care: Implementation toolkit for local systems
NHS England 10 October 2018

• This document sets out some practical ways in which organisations can collaborate locally to implement the NHS Standard Contract provisions relating to primary and secondary care.

Consultation on contracting arrangements for Integrated Care Providers

Consultation on contracting arrangements for Integrated Care Providers (ICPs)

NHS England 3 August 2018

• The consultation provides more detail about how the proposed ICP Contract would underpin integration between services, how it differs from existing NHS contracts, how ICPs fit into the broader commissioning system, and which organisations could hold the ICP Contract.
• Consultation period runs from 3 August to 26 October 2018.
• Documents include:
• The Draft ICP contract
• Particulars
• Service Conditions
• General Conditions
• Explanatory notes to the draft ICP Contract
• Draft Directions
• Draft template GP Integration Agreement
• GP Integration Agreement FAQs
• Draft Equality and Health Inequalities Analysis
• CCG roles where ICPs are established (clarification of the policy positions around: whether ICPs are allowed to manage third party contracts; and the handling of Individual Funding Requests.
• An overview of integrated budgets
• Incentives framework for ICPs

NHS Standard Contract 2017-19 and National Variations

NHS Standard Contract 2017-19 (January 2018 edition) and National Variations
NHS England 4 January

• The following documents have been published on the NHS Standard Contract web page: full length NHS Standard Contract 2017-19 (January 2018 edition), shorter-form NHS Standard Contract 2017-19 (January 2018 edition), NHS Standard Contract 2017-19 Technical Guidance (updated for January 2018) and NHS Standard Contract National Variations and Guidance and comparison documents.

ACO contract and supporting documents

Accountable Care Organisation (ACO) Contract and supporting documents
NHS England 7 August 2017

• Following consultation NHS England has published revised Accountable Care Organisation (ACO) Contract and supporting documents for use by local commissioners to inform the early stages of their procurement processes. The Contract can now be used for accountable care models generally, including MCP and integrated primary and acute care system (PACS) models.
• Documents include:
• Integrating care: contracting for accountable models
• Accountable Care Organisation (ACO) Contract
• ACO Contract Particulars
• ACO Contract Service Conditions
• ACO Contract General Conditions
• Explanatory notes to the Contract
• Summary of engagement feedback
• Template Integration Agreement – overview
• Template Integration Agreement for partially integrated ACOs
• Procurement and assurance approach
• GP participation in an MCP
• ACOs and the NHS commissioning system
• Finance and payment approach for ACOs
• Whole population models of provision: Establishing integrated budgets
• Incentives framework for ACOs
• Accountable models and NHS Pensions
• Contract package Questions and Answers

Guidance -NHS procurement transparency

NHS procurement transparency: NHS Standard Contract - Guidance
NHS England updated 12 May 2017

• This updated document provides guidance to all NHS foundation and non-foundation trusts on the actions to take to increase openness and clarity about NHS procurement. 
• The actions focus on:
• opening up public procurement
• being transparent about expenditure
• sharing expenditure data

NHS Standard Contract training audio presentation and Delta Views

NHS Standard Contract 2017/18 and 2018/19: training audio presentation and Delta Views
NHS England 18 November 2016

• Three audio presentations relating to the NHS Standard Contract 2017-19 have been published on the NHS England YouTube channel. 
• an overview of the contract 
• new policy requirements
• contract management. 
• A slide pack and audio transcript and Delta View documents have also been published showing the changes between the 2016/17 contract and the 2017-19 contract, and between the 2017-19 draft contract and the 2017-19 final contract.

NHS Operational Planning and Contracting Guidance 2017 – 2019

Delivering the Forward View: NHS Operational Planning and Contracting Guidance 2017 – 2019
NHS England and NHS Improvement, 22 September 2016

• The Planning Guidance provides local NHS organisations with an update on the national priorities for 2017/18 and 2018/19, as well as updating on longer term financial challenges for local systems.
• The guidance covers two financial years and is underpinned by a two-year tariff and two-year NHS Standard Contract.
• Drawing on existing data collections from the assurance frameworks, NHS England will publish core baseline STP metrics in November 2016 around Finance, Quality and Health outcomes and care redesign.
• NHS England expect all contracts to be signed by 23 December 2016 - see the timetable for deadlines around publications, submission and mediation processes.
• The business rules for commissioners for 2017/18 and 2018/19 are set out in full in Annex E of the accompanying technical guidance.

Commissioning in the evolving system (p29) - this section outlines the future role of CCGs

"CCGs’ role will continue to evolve. As new care models are established, the boundary between what is done by CCGs and by new integrated care providers will shift. However, there will continue to be a need for an effective commissioning function in the NHS. This includes acting as funder, setting local priorities and incentives, oversight of contracts, ensuring best value for the taxpayer, and ensuring the provision of a comprehensive local NHS within the available resources."

GP Five Year Forward View delivery update

General Practice services
NHS England Board meeting 28 July 2016

• This update given at the NHS England board meeting on delivery of the GP Five Year Forward View. 
• The paper presented gave updates on the following:
• Proposals to support GPs with rising cost of indemnity following a GP Indemnity Review
• A new Practice Resilience Programme, 
• A new national general practice development programme which will provide tailored support for groups of practices to implement the 10 High Impact Actions to release time for care
• Improvements to the GP retainer scheme
• Letter to Trusts and CCGs about the changes in the NHS Standard Contract Document 
• Read the NHS England news item here.

Improving how hospitals work with general practice - changes to Standard Contract

Improving how hospitals work with general practice – new requirements on hospitals in the NHS Standard Contract 2016/17
NHS England 28 July

• In a letter to CCGs NHS Engalnd has laid out six new requirements in NHS Standard Contract for hospitals in relation to hospital/general practice interface.
• Requirements in full:

1. Local access policies Hospitals cannot adopt blanket policies under which patients who do not attend an outpatient clinic appointment are automatically discharged back to their GP for rereferral. Hospitals must publish local access policies and demonstrate evidence of having taken account of GP feedback when considering service development and redesign. 
2. Discharge summaries Hospitals are required to send discharge summaries by direct electronic or email transmission for inpatient, day case or A&E care within 24 hours, with local standards being set for discharge summaries from other settings. Discharge summaries from inpatient or day case care must also use the Academy of Medical Colleges endorsed clinical headings, so GPs can find key information in the summary more easily. Commissioners are also required to provide all reasonable assistance to providers in implementing electronic submission. 
3. Clinic letters Hospitals to communicate clearly and promptly with GPs following outpatient clinic attendance, where there is information which the GP needs quickly in order to manage a patient’s care (certainly no later than 14 days after the appointment). For 2017/18, the intention is to strengthen this by requiring electronic transmission of clinic letters within 24 hours. 
4. Onward referral of patients Unless a CCG requests otherwise, for a non-urgent condition directly related to the complaint or condition which caused the original referral, onward referral to and treatment by another professional within the same provider is permitted, and there is no need to refer back to the GP. Re-referral for GP approval is only required for onward referral of non-urgent, unrelated conditions. 
5. Medication on discharge Providers to supply patients with medication following discharge from inpatient or day case care. Medication must be supplied for the period established in local practice or protocols, but must be for a minimum of seven days (unless a shorter period is clinically necessary). 
6. Results and treatments Hospitals to organise the different steps in a care pathway promptly and to communicate clearly with patients and GPs. This specifically includes a requirement for hospitals to notify patients of the results of clinical investigations and treatments in an appropriate and cost-effective manner, for example, telephoning the patient.

See all  2016/17 Standard contract documents here.

Use of contractual mechanism in commissioning

Study of the use of contractual mechanisms in commissioning
PRU Comm, May 2015

• This three year project investigated how commissioners negotiated, specified, monitored and managed contractual mechanisms to improve services and allocate financial risk in their local health economies, looking at both acute services and community health care. 
• A series of three in depth case studies of three local health economies and telephone surveys (2012/ 2014) found that most of the contractual relationships between NHS owned acute providers and commissioners were characterised by the use of general annual financial settlements outside the terms of the National Tariff rules and the contract. 
• Financial incentives (CQUINs) to improve quality contained in contracts were in widespread use. However, CQUINs were seen as time consuming to negotiate and monitor. There was concern that there were too many different CQUINs each year, and some areas had started to reduce the numbers used.

NHS Standard Contract 2015/16 - discussion paper

NHS Standard Contract for 2015/16: Discussion paper for stakeholders
NHS England, August 2014

• NHS England are seeking views on a number of key issues around practical processes for managing the contract and  about how it works as a tool for commissioners and providers.
• Consultation ends 12 September 2014

CQUIN variations

CQUIN variations
NHS England 23 May 2014

• NHS England has published a full list of publication templates for CQUIN variations to support the 2014/15 NHS Standard Contract.

2014/15 NHS standard contract

2014/15 NHS standard contract
DH, December 2013

• The NHS Standard Contract is mandated by NHS England for use by commissioners for all contracts for healthcare services other than primary care.
• This page includes links to the e portal, CQUIN changes, contractual changes and technical guidance.

Guide to the new Standard Contract 2013/14

NHS Standard Contract - Guide for Clinical Commissioners on the e-contract portal
NHS Supply2health, Live from 8 February 2013

• This new Guide for commissioners is on the 2013/14 NHS Standard Contract e-contract portal
• The Standard Contract is used when commissioning healthcare services (other than those commissioned under primary care contracts) and is adaptable for use for a broad range of services and delivery models. 
• The Guide for Clinical Commissioners is on the Learning Zone.

Models of clinical contracts - supporting the Standard contract

NHS Standard Contract - Guide for Clinical Commissioners
NHS CB, February 2013

• An introduction to the NHS Standard Contract (see all current documents here) including how it can be used innovatively by CCGs,  a description of different models of contracting, and a glossary.