To ask the Secretary of State for Health, whether safeguards are in place to ensure that the new model Accountable Care Organisation contract, published by NHS England in August 2017, will not result in fewer NHS services being provided than under the traditional NHS standard contract; and if he will make a statement.
The published draft Accountable Care Organisations (ACO) contract is still at prototype stage. NHS England has already undertaken wide engagement on this contract, including specific engagement on an early version in December 2016. Responses to the engagement exercise informed further development of an updated version of the draft ACO contract published in August 2017. NHS England is undertaking ongoing engagement through a series of clinical commissioning groups (CCGs)-specific and national workshops.
NHS England considers that it would be not be appropriate to conduct a formal consultation on the draft ACO contract at too early a stage in its development. NHS England is working closely with a number of CCGs which are actively pursuing ACO models for their populations. In doing so, they will test and further develop the draft ACO contract in the context of, and with the benefit of learning from, live procurement processes over the course of the coming months.
NHS England will then conduct formal consultation on an updated draft ACO Contract in accordance with regulation 18 of the National Health Service Commissioning Board and CCGs (Responsibilities and Standing Rules) Regulations 2012 in due course, likely 2018, before mandating its use for ACO models.
It is for local commissioners to commission services according to the needs of their local population. The Commissioner must run a procurement process that is compliant with the principles of transparency and equal treatment.
The CCG would need to be satisfied that the bidder can effectively provide the services in the required locality as specified within the tender, and the commissioner can design the award criteria to reflect the service being contracted, so could include, for example: ensuring quality, continuity of service, accessibility, affordability, availability, Care Quality Commission assessment, needs of vulnerable patients, teaching accreditation, continuity, and comprehensiveness of the services etc. Neither the advert nor the criteria should specify the organisational form of the body that will be awarded the contract. It will be for bidding providers to determine the ownership model of that provider.
This contract is designed to support the development of new, integrated providers that dissolve boundaries between primary, community, mental health, social care, and acute services. In developing a bid to deliver an ACO, prospective providers will need to agree an organisational form and to demonstrate they have support from general practitioners as well as other local NHS providers. Over time, we would expect ACOs to build connections with smaller, voluntary sector providers, enabling them to make a valuable contribution.