New Care Models and STPs roundup
Hempsons is pleased to bring you the latest in its series of news updates on new care models, STPs and integration.
1. STPs will get ‘decision rights’ to reorganise trusts and CCGs
NHS England chief executive Simon Stevens told the body’s board meeting the STPs were “here to stay” and the Five Year Forward View delivery plan, due next month, would “beef up the implementation capability which exists at STP level”.
Mr Stevens said the delivery plan will propose STPs are given “decision rights”, “not only over many of our activities, but also the ability to recommend changes to the configuration or governance of constituent statutory organisations in those geographies where the STP believe that veto power or inertia is getting in the way of the bigger strategic change agenda, which is required in that part of the country”.
This raises interesting governance issues, which are addressed in the report we have launched in partnership with NHS Providers, Governing for transformation: STPs and governance.
2. Integrated commissioning
Integrated commissioning arrangements are increasingly being seen as a mechanism for improving coordination of decision-making by multiple commissioners. This may take the form of integrated commissioning between multiple CCGs or between CCGs and local authorities. By way of example:
1. HSJ reports that two clinical commissioning groups are aiming to merge within weeks, marking the end of a three year moratorium and potentially the beginning of a wave of consolidation. Aylesbury Vale and Chiltern CCGs, both in Buckinghamshire, have applied to NHS England merge at the beginning of 2017-18.
2. HSJ also report that five north London clinical commissioning groups have appointed a single chief officer to cover their entire sustainability and transformation footprint. Helen Pettersen, a former commissioning support unit managing director, has been named as the chief officer for Barnet, Camden, Enfield, Haringey and Islington CCGs.
There are numerous other examples too. Please contact us if you would like to discuss the legal and governance implications of integrated commissioning.
3. Dalton: Ten ways to speed up the Forward View
One of the NHS’s most influential chief executives, Sir David Dalton, has written a helpful commentary piece in HSJ identifying ten priorities to speed up delivery of the Five Year Forward View. He says that despite good work on integration and new models of care, it is taking too long to deliver improvements. Amongst his suggestions to speed up delivery are a series of policy changes including abolishing national access targets, mergers of CCGs, new provider governance arrangements and investment in ‘digital’.
4. Estates update: Strategic Estates Partnerships: investing in challenging times
Trusts are increasingly turning to partnerships with the private sector to develop their estates at a time of financial constraint. Hempsons partner Crispin Pettifer looks at some of the benefits they offer.
“A strategic estates partnership (SEP) can help to resolve the challenges of investing to improve patient experience despite tight financial constraints. A SEP may help you to make the most of your powers and autonomy.
Unlike many projects with the private sector, a SEP is intended to be long term and strategic rather than focusing on a single project. That means it can look wider than a single building or improvement and can start to meet wider needs across the local health and care economy.
From a trust’s perspective, it can be easier and less expensive to procure than a series of smaller deals. Once a joint venture partner has been selected, the JV can be used for a wide range of projects and service initiatives and they will only be delivered through the SEP if doing so will be better value than other alternatives – such as via other existing frameworks or stand-alone procurement.”
5. Estates update: Mapped: Cost of backlog hospital repairs facing every STP area
The current pressures on acute services could prevent or delay crucial improvements that need to be made to hospital buildings, according to NHS estates directors. Analysis by HSJ has revealed the extent of backlog maintenance issues within each health economy in England.
Hempsons Partner Crispin Pettifer comments: “Whilst clinical direction must be the principal steer, STPs provide new opportunities to find solutions to deal with on-going estate maintenance backlogs by taking a wider strategic approach.
Alliance contracting could support implementation of solutions: (for example in estate rationalisation and focussing on the most cost effectively available facilities) with the risks and rewards being shared across providers. The opportunities for joint working through partnership boards and allocation of risks and rewards across multiple organisations should help alleviate backlog maintenance issues.
Another potential resource are Strategic Estates Partnerships which are taking off and offer new opportunities to find commercial funding routes to reconfigure clinical offerings and produce estates efficiencies at the same time.”
For information about alliance contracting please see the Introduction in our integrated Resource Centre.
6. Pioneering ‘Accountable Care Organisation’ (ACO) delayed
Northumbria Healthcare NHS Foundation Trust’s plans to set up an “accountable care organisation” has been delayed. Originally planned to go live in April 2017, the ACO plans to take on the budgets for all services except core primary care for a population of about 320,000. Board papers from Northumberland CCG reveal a “number of milestones” still need to be achieved and no date has been given for when the ACO will now launch.
A number of ACOs are now developing in the NHS – watch this space for news on them during 2017.
For information about ACOs in the NHS please see our introduction in our Integrated Resource Centre.
7. Integration Resource Centre
Hempsons’ Integration Resource Centre contains a series of articles and in-depth reports on new care models, integration, STPs and governance.
Have a browse through the available topics and contact us if you have any questions.
We hope you found something of interest in our roundup. For more information on how any of the issues may affect your organisation, please contact us.