NHS Wakefield CCG
In order to meet its objective of improving patient outcomes and reducing hospital admissions, NHS Wakefield CCG considered a range of options to structure integrated health and social care delivery models.
The CCG’s initiative, known as “Connecting Care”, involves a range of providers of health and social care services working together, alongside the CCG and local authority, as commissioners. The objective of this being to connect and integrate out of hospital services across organisational and contractual boundaries, and work to achieve a set of common outcomes for patients. The providers involved are diverse and range from an NHS Trust to voluntary sector organisations and GP providers, each delivering existing services under different contractual arrangements with the commissioners.
Overcoming the challenges
Bringing together diverse contractual arrangements - we drafted an agreement setting out how the CCG and the local authority as commissioners, will work with the various providers to achieve the common outcomes whilst retaining current (diverse) contractual arrangements. This included integrated governance arrangements and obligations on the providers to integrate existing services to achieve a common set of outcomes and KPIs in a patient-centred way. A particular challenge was to set out how disputes between the partners would be resolved, given existing contractual arrangements in relation to each provider would set out specific dispute resolution procedures which would not always be the same.
Governance and decision making – how the partners would make decisions collectively, and how this would link into existing accountability structures, including the local health and wellbeing board.
We are now advising the CCG in relation to shadow accountable care structures, building on Better Care Fund arrangements and building in the CCG’s vanguard projects.
As part of our work with the CCG, we have developed a commissioning assurance process to comply with the CCG’s procurement obligations including those set out in the NHS (Procurement, Patient Choice and Competition) (No.2) Regulations 2013. We are currently adapting this process to reflect the Public Contracts Regulations 2015 which will come into force for all CCGs on 18 April 2016.