STPs and accountable care roundup w/c 27 November

Hempsons is pleased to bring you the latest in its series of news updates on STPs and accountable care.

NHS Improvement publishes revised Transactions Guidance

NHS Improvement (NHSI) has published Transactions guidance – for trusts undertaking transactions, including mergers and acquisitions which replaces Monitor’s previous guidance from March 2015 and the NHS Trust Development Authority’s guidance from June 2015. This guidance will be relevant to any trust transactions which take place as part of the development of accountable care models, for example where services and assets transfer from one trust to another.

The main change in the guidance is to reduce the stages in the process, doing away with the separate strategic outline case and outline business case, so that trusts are required to produce a more detailed “strategic case” at stage 1. Read more about the revised guidance.

Hempsons, NHS Providers and Aldwych Partners launch “An eight step guide to accountable care – the art of the possible”

Alongside NHS Providers and Aldwych Partners, we have launched our new guide identifying eight key steps STPs and their partner organisations should consider to support the evolution to accountable care. The guide is available here.

Jamie Foster comments: “The move from STPs to accountable care systems (ACSs) and accountable care organisations (ACOs) is picking up pace. Infrastructure is developing to facilitate delivery of accountable care, including NHS England’s draft ACO contract and framework for technology and support services, but it remains the case that moving from numerous sovereign organisations working together in the current system to ACS models and ACO models is complex and challenging. We have sought to demonstrate the ‘art of the possible’ by setting out 8 steps for STPs and their constituent organisations to think about as they take the first steps towards ACSs and ACOs. We hope organisations find it useful”.

Health devolution developments for London

After a long wait, the London health devolution deal has finally been signed off by government, following agreement by the mayor, health secretary, councils and NHS leaders. The HSJ reported that the agreement deal will facilitate new options for the use of proceeds of NHS land sales, more efficient regulation to make it easier for health and care organisations to work in an integrated way and delegated responsibility for commissioning primary care and specialised services. There will also be a London Workforce Board to take a joint approach across health and social care.

Extending access to the NHS pension scheme for accountable care providers?

The government is consulting on ways to ease the access of independent providers and other organisations holding ACO contracts and sub-contracts.

The consultation restates and updates amendments to the scheme which were proposed in 2016. That earlier consultation was withdrawn because of timing issues with finalisation of the MCP framework. This new consultation presents those amendments again, updated to take account of the new ACO contract framework that can also be used to commission the earlier MCP and PACS models. In particular the new amendments address scheme access for employees delivering services that are a combination of NHS and health-related local authority functions. The consultation closes on 29 December 2017. Read the consultation document.


STPs and the pharmaceutical industry – a new relationship?

It would be reasonable to expect Accountable Care Systems to focus on efficiency and cost of medicines, incentivising pharmaceutical companies to demonstrate the short- and long-term value of drugs. New systems mean the NHS can now better validate the efficacy of specific drugs, so the pharmaceutical industry is looking to the transformation funded STP areas as potential “fertile ground” for innovative products that can be proved to offer lower costs. But, say Wilmington Healthcare’s Paul Midgley and Steve How, pharma companies will have to show that they are also willing to embrace change, to increase accountability for results and to take more responsibility for improving patient outcomes.

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