All providers of National Health Service funded care (NHS and independent sector providers) for specialised mental health services are contracted using the same standard NHS national contract. These contracts set out the standard terms of business relating to the provider and commissioner relationship.
The monitoring of performance is undertaken by NHS England centrally and through the contracting hubs. Performance management includes:
- Performance against operational standards within the NHS Contract;
- Reporting against Key Performance Indicators undertaken quarterly and reviewed as part of contract management meetings between commissioner and provider;
- Regular performance review meetings with the provider;
- Measurement against local quality standards developed by individual hubs;
- Measurement of service specification compliance;
- NHS England Hub ward visits;
- The patient satisfaction survey and implementation of service improvements informed by patient feedback; and
- Triangulation with Care Quality Commission inspections.
The Quality Assurance and Improvement Framework sets out the quality assurance and improvement activity undertaken in relation to all specialised commissioned services.
The outcome of the annual assessment has two features:
- Identification of levels of surveillance for the following year; and
- Assessment of compliance and non-compliance and if non-compliant, whether provider action or commissioner action is required.
A framework has been introduced which requires those reviewing and assessing the information on quality, to categorise services into one of three categories to determine levels of surveillance for the following year:
- Routine surveillance – services that have been scored at 100% with no risks identified and those services that have not scored 100% but regional teams have determined that the issue is not material;
- Enhanced surveillance – services in this category will require further discussions between provider organisations and relevant commissioning teams to determine whether formal provider action or commissioner action is required, or whether after further discussion the service is deemed to be compliant; and
- Peer review visit – services considered for peer review should be discussed with the provider and commissioner to confirm that the factors leading to this proposed option are relevant and proportionate for the action. Based on the level of risk agreed at hub or regional meetings, the service may also be subject to a provider or commissioner action.