NHS Standard Contract consultation: A briefing for system leaders
The NHS Standard Contract is mandated by NHS England for use by commissioners (including NHS England and CCGs) for all contracts for healthcare services other than primary care. As this short briefing sets out, the new Contract will have implications for sustainability and transformation partnerships (STPs) and integrated care systems (ICSs).
What is the NHS Standard Contract?
The NHS Standard Contract is mandated by NHS England for use by commissioners (including NHS England and CCGs) for all contracts for healthcare services other than primary care. As this short briefing sets out, the new Contract will have implications for Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs).
How does the consultation relate to systems?
The draft Standard Contract reflects that providers within STP and ICS footprints will need to bear responsibility for the delivery of system ambitions and objectives. They will be required, for example, to play their part in achieving financial balance and helping to deliver local system plans (once they are published and begin to be implemented).
Further detail on both of these requirements is set out in the draft Contract, which sets out the following:
System-wide collaboration to manage performance and finance | As proposed in the Tariff Engagement Document, NHS England and NHS Improvement reflects in the Contract the expectation that CCGs and NHS Trusts / Foundation Trusts within each ICS/STP will sign, and act in accordance with, an overarching System Collaboration and Financial Management Agreement (SCFMA). This will set out how they will work together to deliver system financial balance. NHS England and NHS Improvement regional teams will also be party to these agreements. A model version of this SCFMA, for local adaptation, is available on the NHS Standard Contract 2020/21 web page. Their approach is intended to set a minimum requirement, not to prevent partners within an ICS/STP from adopting (or retaining) a more ambitious collaboration agreement. |
Supporting implementation of system-level plans | NHS England and NHS Improvement propose to update existing references to Local System Operating Plans so that these relate to the long-term plans which have now been agreed at ICS/STP level for 2020/21 onwards. The Contract will thus continue to require both commissioner and provider to contribute towards implementation of such system-level Plans, with Schedule 8 allowing each party’s obligations under the relevant Plan to be set out in detail, if required, thereby giving them contractual force. |
Overall, the NHS Confederation believes these changes to the NHS Standard Contract should be helpful for systems and indeed are necessary for the successful delivery of system plans. They will ensure that providers are contractually obliged to support their STP or ICS, thereby creating a shared incentive to deliver the ambitions of the NHS Long Term Plan when it comes to integration.
That said, those working within systems may wish to assess how changes to the Standard Contract may affect their own local strategic objectives. Some questions that system representatives may wish to keep in mind as they review the proposed Contract for 2020/21 are:
- Do the requirements on providers go far enough to allow systems to be confident of delivering their local plan?
- What do systems really need from providers and how many of these requirements can, or indeed should, be reflected in the Standard Contract?
How can systems have a say?
NHS England and NHS Improvement is consulting on the draft Standard Contract for 2020/21 until the end of this week (31 January). The full copy of the Contract, as well as technical guidance on the Contract, can be found online.
Comments and feedback can be submitted through NHS England and NHS Improvement’s Consultation Hub. It should be noted that these comments can be as detailed or as brief as you wish, relating to the Contract as a whole or individual elements of it.
The ICS Network is also able to assist with individual responses from systems. If you would like to know more then please get in touch through the contact details below.
Further information
If you have any questions about the NHS Standard Contract or would like to find out more about the ICS Network, please contact William Pett at William.Pett@nhsconfed.org
Further information about the ICS Network can also be found on our website.
