- Procurement, Corporate, Commercial
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The drive for more integrated care as set out in both publications will likely mean that commissioners will be selecting from a different (possibly reduced) provider landscape going forward.
It may be that a combined organisation such as an integrated care organisation could tick many boxes in terms of service specifications and commissioners’ duties to act with a view to services being provided in an integrated way.
There is a tangible sense that commissioners, particularly with regard to community and social care services, are adopting commissioning approaches which aim to deliver joined-up care along the entire care pathway. Providers have responded with joint or multi-organisation tendering across health and social care providers (the increase in alliance contracting is a reflection of this) and new care models could cement that development.
Going forward, commissioners need to consider what their strategy is going to be for commissioning particular services / care pathways under a new care model. Key questions that will need to be considered are:
- What are the current service arrangements and what assets do existing providers have that might need to transfer to new providers?
- Do commissioners intend that providers should be held to account by outcomes or performance indicators or both?
- Will arrangements be funded by traditional methods or capitated budgets?
- Do commissioners want to build in risk/reward mechanisms to incentivise providers?
- What other factors are of importance, for example social value and the involvement of third sector providers?
- What contracting model will allow us to achieve our objectives? (see the next section of this guide)
Once commissioners know the answers to these questions they can consider how they will comply with procurement law duties. Where providers can demonstrate a robust integrated care model, commissioners might be able to award contracts without running competitive tenders. But this will of course depend on what is being commissioned and the healthcare landscape in the relevant area. Commissioners will need to be able to justify any such commissioning decisions to minimise the risk of challenge.
Complying with procurement law – key questions
- Is there a distinct move towards commissioning integrated services in your locality?
- Do commissioners have a clear strategy about what their objectives are?
- Are these objectives best met through a loose collaboration of providers responding to individual tender opportunities?
- Or does the establishment of a more formal integrated care organisation involving multiple providers allow commissioners to award contracts without running competitive tenders?
- Have public sector providers considered procurement law duties when selecting partners?