New NHS Community Contract

The Department of Health (DH) is currently developing a new standard contract for community and mental health services including those delivered by the Voluntary and Community Sector (VCS).

The requirement to develop a standard contract forms part of the Health Reform in England, featuring first in the Commissioning Framework (July 2006) and then again in the Commissioning Framework for Health and Well-being (March 2007) and will be in place for April 2009. The contract will replace all existing contract/s between the VCS and the PCT.

Benefits of the Standard Contract

The Department of Health cites the following benefits to the standard NHS contract:

• A focus on keeping it as simple as possible, using plain English and accompanying guidance to ensure that both commissioner and provider fully understand the contract
• Flexibility; can be amended to account for service and organizational contexts
• A standardized contract will reduce the monitoring and administrative burden on third sector organisations holding more than one contract across different funding streams and different PCTs
• Built in measures to support organisations not meeting their contractual agreements as opposed to an automatic funding cuts
• Opening up commissioning opportunities where the standard contract wasn’t appropriate for VCS organisations e.g. GP commissioning
• Create a ‘level playing field’ across sectors
• Three year contract length default

The overarching aims of the contract being to improve patient experience through quality, joined-up services that represent value for money (VFM).

Local Impact on VCS Organisations
The standard contract will be of interest for any organisation wishing to contract with the NHS in the future and those currently holding contracts that run beyond April 2009. Locally this will affect those organisations with existing contracts through funding streams (namely Bradford and Airedale tPCT commissioning and Healthier Communities Fund), and individual contracts e.g. Practice Based Commissioning. For the districts 86 VCS organisations currently in contract with Bradford and Airedale tPCT this will mean a new contract less than a year after their initial contract has been signed. This is a requirement placed by the DH nationally and therefore out of the hands of the PCTs locally. In reality this should only mean a format adjustment of the contract rather than any major content changes. Our understanding is that the standard contract will also apply to Healthier Communities Fund but we are currently seeking confirmation on this. We will keep you updated! For Healthier Communities Fund schemes this would also signify a move from Service Level Agreements (SLAs) to a legally binding contract.
Organisations should wait to be contacted by their commissioning contact officer.

VCS Planning for NHS Contracts
Though the disruption to existing providers should be minimal the new standard contract serves to further reinforce some of the changes we expect to see as key to future commissioning arrangements.

Take into account these changes through your organisations planning for future funding bids.

Features of the contract:

• Evidence base
• Expected outcomes
• Service delivery model
• Referral routes
• Quality and performance indicators
• Care pathways

Services will be based on proven delivery models and community need. The contracted service will be identified as fitting into the relevant care pathway considering referral routes from and to other services within the pathway. Organisations could identify where their organisations services fit, or may want to position themselves into the relevant care pathway e.g. mental health, smoking cessation. An article outlining how to map your organisations activities to care pathways will follow.

As is now the case with many, but not all existing contracts, performance will be measured by achieving agreed health outcomes rather than outputs.

If you have any questions or comments relating to this article contact either Rachel or Razwanah @ Bradford CVS t: 01274 722772 e: health@bradfordcvs.org.uk . Keep checking the blog for updates!