Alliance contracting, prime contracting and outcome based contracting. A literature review

Alliance contracting, prime contracting and outcome based contracting: What can the NHS learn from elsewhere? A literature review
PRUComm 25 October 2016

• A summary of the findings of a literature review of the available evidence concerning the characteristics of these new models of contracting, such as alliance contracting, prime provider contracting and outcome based contracting, and their implementation in other sectors. 
• The report outlines the characteristics of each model, discusses contract negotiation and specification using the models and potential governance issues in relation to their implementation in the NHS.

Understanding multimorbidity across a whole population

The importance of multimorbidity in explaining utilisation and costs across health and social care settings: evidence from South Somerset's Symphony Project. Kasteridis Pet al
Centre for Health Economics, University of York; CHE Research Paper 96 (2014)

• South Somerset’s Symphony project is designed to establish greater collaboration between primary, community, acute and social care, particularly for people with complex conditions.
• The Symphony Project has an anonymised individual-level dataset, spanning primary, community, acute, mental health and social care. This includes activity, costs, clinical conditions, age, sex and ward of residence for the entire population of 114,874 people in 2012. 
• The research identified the frequency of conditions and co-morbidity profile of the entire population and, for the most frequent conditions, we assess utilization and costs of care across health and social care settings.
• The analysis identifies those groups of the population which are the highest users of services by activity and cost and provides baseline information to allow budgetary arrangements to be developed for these targeted groups. 
• For more information about the project see HSJ Local Briefing : South Somerset integration plan August 2013.
• Update: Somerset abandons alliance ambitions (HSJ 23 September 2014)
• The project by Symphony Project board to improve the integration of care in south Somerset has abandoned its ambition to boost cooperation among providers with an ‘alliance contract’ after concern from GPs and legal advice that the approach would be incompatible with “general medical” and “personal medical services” contracts used in general practice.