The NHS Standard Contract for Mental Health and Learning Disability Services - 15th April 2010 Healthier Horizons

Contracts? A system of rules governing conduct of a relationship There are fewer and fewer NHS Trusts as the provider market changes to a market of ‘legal entities’ (FTs Independent Sector, Third Sector, Social Enterprises etc)

Background Better Care Better Health Better Life The first NHS Standard Contracts commenced April 2007 (Acute Hospitals – one year) The NHS Standard Contract was introduced through the 2007/8 Operating Framework 3 Year contracts for Acute Services commenced April 2008 Community, Ambulance and MH and LD Contracts introduced April 2009 (MH&LD one year only) MH&LD 3 year contract introduced for commencement April 2010 All contracts 3 year Default – Apply to SHA to alter duration.

Who will use the contract? PCTs with all MH & LD providers Creates legally binding Agreements between PCTs and LAs, IS, 3 rd Sector, FTs NHS Trusts treated with the same rigour as if legally binding

When to use the contract? Where the current contract expires on 31/03/10 and is renewed after 31/03/10 Contracts that extend beyond 31/03/10 may subject to agreement choose to adopt the contract from 1/4/10 Any new agreements from April 10 onwards

Structure of the Contract 2 parts - Terms and Conditions - Schedules Colour Coded Elements which are Mandatory Elements that must be there but the detail is to be agreed by the contracting parties Additional elements that can be added by local agreement

Terms and Conditions - Clauses 60 Clauses Clause 7 Prices and Payment - Payment for small providers (less than 50 Fte and 130k Annual Contract value) Clause 8 Review – each month or quarterly (Finance, activity, complaints, variations, schedules) Clause 11 Staff - TUPE, Suitably qualified/experienced Clause 15 Serious Untoward Incident Reporting - (Schedule 12) Clause 16 Quality, Patient Safety and Quality Improvements – respond to Regulator requirements, comply with Law Guidance

Terms and Conditions - Clauses Clause 19.1 New right to inspect Provider’s premises Clause 26 Liability and Indemnity – appropriate indemnity for employers’ liability, public liability, professional negligence etc Clause 27 Data Protection and Freedom of Information Clause 28 Dispute Resolution - Mediation, Independent binding Adjudication Clause 34 Suspension –New suspension right: to deal with the SHA discretion to suspend contracts that are demonstrably not operating in patients’ best interests (clause ). Clause 35 Termination – 12 months notice

Terms and Conditions - Clauses Clause 38 has been adjusted across all contracts along the lines of the 2009 Community Contract The variations have been divided as follows –National Variations introduced with a 3 month notice period –Service Variations Those where staff are not materially impacted – 3 month notice period Those where staff are materially impacted – 6 month notice period –Other variations by agreement

Schedules (21) Schedule 1 definitions

DH copyright Service Specifications (Schedule 2 Part 1) Standard template Collaboration between commissioners and providers Move towards specification on basis of care clusters? Regular update

Service Specification

DH copyright Service Specifications (Schedule 2 Part 2,3,4,) Part 2 - Essential Services -Mandatory but for local agreement – (List any essential services which it is not appropriate to allow the Provider to suspend or withdraw) probably not applicable Part 3 – Activity Plans -Mandatory but for local agreement Part 4 - Expected Annual Contract Values – Insert details of the agreed calculation of the agreed contract value

DH copyright Quality Schedule (Schedule 3) Part 1 Quality Requirements National priorities Mandated items (e.g. People with LD should be able to access main stream services when necessary) and for Local determination (e.g. Access to psychological therapies should be improved) Part 2 Nationally specified events DSSA, 18weeks, inpatient Suicide by use of non Collapsible Curtain rail.

DH copyright Quality Performance Incentive Schemes (Schedule 4) National, Regional and local schemes CQUIN payment framework - embed quality improvement and innovation - agreement on local goals which do not duplicate quality requirements - 1.5% of contract value - 50% of expected monthly sum paid up front - monitor at least quarterly

DH copyright The roles of the different contract levers Service Specification & Quality Schedule CQC Requirements Requirements for non- regulated services CQUIN Scheme Optional Local incentive Scheme Stretching goals where achievement results in incentive payments Baseline targets where there are consequences for non-achievement

DH copyright Information Schedule (Schedule 5) 3 parts:- 1- centrally reported national requirements (e.g. reporting for the national drug treatment reporting system, 18 weeks where appropriate) 2- locally reported national requirements (e.g. monthly activity and quality reports) 3- suggested priorities for local definition and reporting (e.g. service specific data) plus ‘Data quality improvement plan’

DH copyright Mental Health and Learning Disability Services Contract Schedule 6 Service Variations, National variations and other variations Schedule 7 Managing Activity and referrals Emergency and Crisis Control Procedure Transfer of and Discharge from Care Schedule 8 Transition (Regulators registration, Business continuity Plan, DSSA plan) Managing activity and referrals

DH copyright Mental Health and Learning Disability Services Contract Schedule 9 Dispute Resolution Procedure Schedule 10 Provider’s Material Sub-Contractors Schedule 11 Commissioning Intentions, Service Development and Improvement Plan (a new plan to drive service improvements in quality), Partnership Agreements (LA), Safeguarding Policy, Surveys and Consortium Agreement Schedule 12 Serious Untoward Incidents and patient Safety Incidents

DH copyright Mental Health and Learning Disability Services Contract Schedule 13 NHS Counter-Fraud and Security Management Schedule 14 Documents Relied On (e.g. Certificates) Schedule 15 Change in Control Notification Schedule 16 Intellectual Property Rights Schedule 17 Notices

DH copyright Local Authority Requirements (Schedule 18) Introduction of Schedule 18 Where a local Authority is a party to the contract any specific local requirements should be inserted here. Local authority requirements in other parts of contract

DH copyright Mental Health and Learning Disability Services Contract Schedule 19 Not Used! Schedule 20 Clinical networks and Screening Programmes Schedule 21 Provisions that may be varied (list of schedules that may be varied by the parties is set out)

DH copyright Contract Review & Control Remedy before penalty Contract reviews - at least quarterly - covers service quality, finance and activity, information, contract management issues Contract controls - failure to provide information - failure to meet service standards - breach in performance - suspension and termination

DH copyright Contract Performance (Clause 32 and 33)

DH copyright Mental Health and Learning Disability Services Contract: what you need to do Bilateral or multilateral Service specifications Activity plan Quality requirements Quality performance incentive schemes Information requirements Data quality improvement plans Service development and improvement plans Social care requirements

Further information Better Care Better Health Better Life All the contracts and their guidance can be found at: licyAndGuidance/DH_ queries to :- or to your local PCT Contract Lead Thank you and any questions? Janet Collinson, Assistant Director, NHS Northwest