New Standard NHS Community Contracts Part 1 April 2009 Christian Geisselmann Consultant – Contracts & Commissioning NHS South of Tyne and Wear - Substance Misuse Commissioning Teams

Objectives of Today NHS South of Tyne and Wear Substance Misuse commissioning Teams World Class Commissioning Overview of New Community Contract & Mental Health and Learning Disability Contract Contract and Performance Management & Framework Quality Assessment Framework, Value for Money, CQUIN Service User Engagement Questions??????

NHS South of Tyne and Wear “NHS South of Tyne and Wear covers Gateshead Primary Care Trust (PCT), South Tyneside Primary Care Trust (PCT) and Sunderland Teaching Primary Care Trust (TPCT) and is the name given to the integrated management arrangements which exist across the three PCTs. This means that, whilst each PCT remains a statutory organisation in its own right, the day-to-day management of the PCTs has been brought together under a single management team”

‘Our Vision’ “Working together to make South of Tyne and Wear healthy for you” The Key to: Better Health Longer life Better quality of life Fair access to services Excellent Patient Experience Safe care Effective treatment Quality services Using your money wisely Right services, right place, right time Reducing waste Value for money

The vision for World Class Commissioning

Setting the Context A shift in focus towards commissioning Initially looked at process and structure World class commissioning programme Focusing on vision and content “Adding life to years and years to life”

Why world class? World-class commissioning is a statement of intent aimed at raising ambitions and dramatically transforming the way we work

Vision: World class commissioning will deliver Better health and well being for all People stay healthier for longer – “adding life to years.” People live longer and health inequalities are dramatically reduced – ”…and years to life” Better care for all Services are of the best clinical quality and evidence based People exercise choice and control over the services that they access so they become more personalised. Better value for all Informed investment decisions PCTs work across organisational boundaries to maximise effective care

How will it be delivered? PCT's will lead the program Clinical engagement and innovation Will drive improved outcomes Partnership is key to success WCC will be delivered locally

What will success look like? Clear local priorities and long term strategy, to tackle local health issues Vibrant, effective partnerships Population actively engaged Innovative practice based commissioners working to an agreed PCT wide strategy . . . But leaving room for very local initiatives People staying healthier for longer People living longer Inequalities gap narrowing

Overview of the New Community Contracts The New Standard NHS Contract for Community and Mental Health Services: The Department of Health has developed two new standard contracts which will be used on a mandatory basis by Primary Care Trusts from April 2009 The Standard Contracts will be used for health and care services with any provider for new contracts commencing on or after 1st April 2009 There is one for general community based services and another for specialist mental health / learning disability or substance misuse services

Overview of the New Contracts “These will sit alongside the standard contract for acute hospital services and the primary care contracts. The contracts contain standard legal terms which cannot be changed and a service specification template for completion at a local level for each service. The standard legal terms are there to provide the basis for equal partnership working between all parties, and include for example review arrangements and dispute resolution procedures”

Contracts “The standard contracts are not intended to be used for activity that would be more appropriately funded through a grant process. Alongside the standard contracts we are reinforcing with PCTs the role of grant funding for organisations, particularly those providing lower level community based support. The National Audit Office Decision Support Tool can be used to support decision making on the most appropriate funding mechanism to use”

Community Contract: From April 2009 the Community Contract will be introduced on a three year basis to expire on 31st March 2012 The DH guidance describes that Substance Misuse Commissioning teams (previous DAT or DAAT) may also use the Community Contract however makes it clear that it is at the Commissioners discretion as depending on the type of Substance Misuse Service the Mental Health and Learning Disability Contract maybe more appropriate

Mental Health Contract From April 2009 the Mental Health & Learning Disability Contract will be introduced on a one year basis to expire on 31st March 2010 This guidance will apply to the interim year agreements made by PCT's with all Providers of Mental Health and Learning Disability Services The DH guidance describes that Substance Misuse Commissioning Teams (previous DAT or DAAT) may also use the Mental Health and Learning Disability Contract however makes it clear that it is at the Commissioners discretion as depending on the type of Substance Misuse Service the standard Community Contract maybe more appropriate

Mental Health Contract cont… Where both the PCT and the Provider have a well developed contract in place and agree that their current contract arrangements would benefit from continuing until April 2010 Then subject to SHA approval, the parties can continue to contract under existing arrangements. PCTs will ensure that any extension to current contracting arrangements will not continue beyond 2010.

So why have the new contracts been developed? “The new contracts are a tool to support commissioning at a local level by providing the basis of good practice when contracting with providers. It will also reduce the duplication and cost of legal and administrative costs at a local level”

What will implementation bring? Commissioners and the Department of Health hope that by implementing the new contract that it will allow: Improved outcomes for patients Give greater a patient experience, say and choice National standards and national contracts giving consistency Improved service delivery, performance & greater value for money Allow a review of ALL existing services and systems (Strategic Reviews by Commissioners, New Service Specifications, Internal systems review, etc……..) Implementation of new systems where appropriate and recommendations are made Commissioning of new services or service redesign where appropriate and recommendations are made Consistency across all contracts & services with improved care pathways Ability to monitor performance much more closely Further enhancing the World Class Commissioning agenda and Darzi recommendations

So what exactly do the new Contracts mean? The new contract will mean changes to the way that we operate as outlined below: One overarching contract that covers all services with a provider Individual service specifications underpinning the contract Greater competition between providers Provide greater quality services and achieve better value for money Commissioner / Provider split Contractual obligations to Commissioners Cultural changes Service reviews and changes Systems reviews and changes Regular performance and contracts meetings Provide commissioners with monthly reports and data Accountability & Legal Obligations Financial Penalties for breach of contract, poor performance

What is available to us? A Commissioners & Providers Guide to both the Community Contract and Mental Health Contract have been written by NHS South of Tyne and wear Bilateral and Multilateral Mental Health and Community Contracts Service Specification Templates Action Logs for Contract Negotiations for Mental Health and Community Contract Improvement Plans Contract Management Meeting Agendas NHS Contract Variations Performance Notice Templates Quality Assessment Framework and Guide plus QAF Self Assessment and Score Sheet Performance & Contract Workbook Treatment Plan A Copy of all the supporting documents and guides will be sent to all providers on CD

What is yet to be developed? Commissioning Policy De Commissioning Policy Value for Money policy Procurement Policy

Next Steps today….. Why the Mental Health Contract and what is it? What are the timescales and how will we implement? What is Contract and Performance Management? How will the QAF work? What about Value for Money and CQUIN What are the timescales?

Thankyou & Any Questions? Christian Geisselmann Consultant – Commissioning & Contracts South Tyneside PCT Substance Misuse Commissioning Team NHS South of Tyne and Wear 17 Beach Road South Shields Tyne & Wear NE33 2QA   Telephone: 0191 4967963 xxxxxxxxxx@xxxxxxxxxxxxxxxx.xxx