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

2. 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??????

3. 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”

4. ‘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

5. The vision for World Class Commissioning

6. 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”

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

8. 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

9. 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

10. 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

11. 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

12. 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”

13. 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”

14. 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

15. 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

16. 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.

17. 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”

18. 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

19. 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

20. 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

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

22. 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?

23. 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: