As policy makers continue to push the NHS towards integrated services at scale, commissioners and providers continue to wrestle with contractual issues that threaten to slow progress or stop it in its tracks. In the latest in our series of events on contracting for new care models, delegates have the opportunity to hear from Robert McGough of specialist lawyers Hill Dickinson, who has advised the NHS on the legal implications of integrated care, alliance contracts and the emerging contracts for new care models. Robert is joined by Anton Obholzer, head of implementation, multispecialty community provider contracting, NHS England. The event gives delegates the opportunity to get first-hand intelligence about the new contracting tools and share learning about how to apply them in practice. It focuses particularly on the options in the new contracts designed to encourage GPs to engage in new care models without making all-or-nothing decisions about their contractor status. Delegates to this event in London praised it for “contextualising the full picture”, “extremely useful case studies” and for insights to the “direction of travel and different types of structures”. A limited number of places remain for the next event in Warrington on 15 November.
Commissioners will play an important role in empowering providers to work together to establish the collaborations that may evolve to become the accountable care systems of the future. As delegates at a recent PCC event on contracting for new care models heard, commissioners need to work with providers, particularly GPs, to enable them to choose the contractual and organisational forms that are right for them as well as for the local population. Our advisers are working with CCGs not only to help them to understand the different options in the new ACO contract but on the detailed financing issues likely to impact local decisions. For example we worked with one CCG to identify GP practice income and expenditure streams. This will help the CCG establish what funding is available to establish a salary range for GPs who opt to move from GMS/PMS contracts to salaried working for the planned multispecialty community provider (MCP).
Find out more about this and other contracting issues in these four articles.
In August NHS England published documents setting out current thinking on the relationship between GPs, practices and various forms of accountable care organisations (ACOs). The papers included a new version of the ACO contract that will evolve further over the coming months.
A key issue is how GPs can be encouraged to participate in integrated delivery models.
Virtual integration: Existing contracting arrangements (including GMS and PMS contracts) would remain in place but be underpinned by an “alliance agreement”. This agreement would set out a vision, a commitment to managing resources together, the delivery of services and clear governance to allow elements of joint decision making. This model gives organisations an opportunity to jointly develop a more collaborative care system rather than an accountable care organisation.