The NHS Standard Contract for Mental Health and Learning Disability Services - 15th April 2010

Healthier Horizons

Contracts?

• A system of rules governing conduct of a relationship

• There are fewer and fewer NHS Trusts as the provider market changes to a market of ‘legal entities’ (FTs Independent Sector, Third Sector, Social Enterprises etc)

Background

Better Care Better Health Better Life

•The first NHS Standard Contracts commenced April 2007 (Acute Hospitals – one year)

•The NHS Standard Contract was introduced through the 2007/8 Operating Framework

•3 Year contracts for Acute Services commenced April 2008

•Community, Ambulance and MH and LD Contracts introduced April 2009 (MH&LD one year only)

•MH&LD 3 year contract introduced for commencement April 2010•All contracts 3 year Default – Apply to SHA to alter duration.

Who will use the contract?

• PCTs with all MH & LD providers

• Creates legally binding Agreements between PCTs and LAs, IS, 3rd Sector, FTs

• NHS Trusts treated with the same rigour as if legally binding

When to use the contract?

• Where the current contract expires on 31/03/10 and is renewed after 31/03/10

• Contracts that extend beyond 31/03/10 may subject to agreement choose to adopt the contract from 1/4/10

• Any new agreements from April 10 onwards

Structure of the Contract2 parts - Terms and Conditions- Schedules

Colour Coded • Elements which are Mandatory• Elements that must be there but the detail is to be

agreed by the contracting parties• Additional elements that can be added by local

agreement

Terms and Conditions - Clauses

• 60 Clauses

• Clause 7 Prices and Payment - Payment for small providers (less than 50 Fte and 130k Annual Contract value)

• Clause 8 Review – each month or quarterly (Finance, activity, complaints, variations, schedules)

• Clause 11 Staff - TUPE, Suitably qualified/experienced

• Clause 15 Serious Untoward Incident Reporting - (Schedule 12)

• Clause 16 Quality, Patient Safety and Quality Improvements – respond to Regulator requirements, comply with Law Guidance

Terms and Conditions - Clauses

• Clause 19.1 New right to inspect Provider’s premises

• Clause 26 Liability and Indemnity – appropriate indemnity for employers’ liability, public liability, professional negligence etc

• Clause 27 Data Protection and Freedom of Information

• Clause 28 Dispute Resolution - Mediation, Independent binding Adjudication

• Clause 34 Suspension –New suspension right: to deal with the SHAdiscretion to suspend contracts that aredemonstrably not operating in patients’ bestinterests (clause 34.1.9).

• Clause 35 Termination – 12 months notice

Terms and Conditions - Clauses

• Clause 38 has been adjusted across all contracts along the lines of the 2009 Community Contract

• The variations have been divided as follows

– National Variations introduced with a 3 month notice period

– Service Variations

• Those where staff are not materially impacted – 3 month notice period

• Those where staff are materially impacted – 6 month notice period

– Other variations by agreement

Schedules (21)

Schedule 1 definitions

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Service Specifications (Schedule 2 Part 1)

• Standard template

• Collaboration between commissioners and providers

• Move towards specification on basis of care clusters?

• Regular update

Service SpecificationSchedule 2 Part 1: Service Specifications Mandatory headings Sections 1-3. Mandatory but detail for local determination and agreement. Optional headings Sections 4-6. Optional to use, detail for local determination and agreement. Subheadings for local determination and agreement]

SERVICE SPECIFICATION

Service/ Care pathway/ Cluster

Commissioner Lead

Provider Lead

Period

Date of Review

1. Purpose

1.1 Policy context 1.2 Local strategic context 1.3 Aims and objectives of the service

2. Service Scope

2.1 Service user groups covered (including care clusters, where relevant) 2.2 Exclusion criteria 2.3 Geographical population served 2.4 Service description/ care package- overview ie what is provided

- assessment - care planning - interventions etc

3. Service Delivery

3.1 Location of service 3.2 Days/ hours of operation

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Service Specifications (Schedule 2 Part 2,3,4,)

• Part 2 - Essential Services -Mandatory but for local agreement – (List any essential services which it is not appropriate to allow the Provider to suspend or withdraw) probably not applicable

• Part 3 – Activity Plans -Mandatory but for local agreement

• Part 4 - Expected Annual Contract Values – Insert details of the agreed calculation of the agreed contract value

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Quality Schedule (Schedule 3)

Part 1

• Quality Requirements National priorities Mandated items (e.g. People with LD should be able to access main stream services when necessary) and for Local determination (e.g. Access to psychological therapies should be improved)

Part 2

• Nationally specified events DSSA, 18weeks, inpatient Suicide by use of non Collapsible Curtain rail.

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Quality Performance Incentive Schemes (Schedule 4)

National, Regional and local schemes

• CQUIN payment framework

- embed quality improvement and innovation

- agreement on local goals which do not duplicate quality requirements

- 1.5% of contract value

- 50% of expected monthly sum paid up front

- monitor at least quarterly

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The roles of the differentcontract levers

Service Specification & Quality Schedule

CQC Requirements

Requirements for non-regulated services

CQUIN Scheme

Optional Local incentive Scheme

Stretching goals where achievement results in incentive payments

Baseline targets where there are consequences for non-achievement

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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Information Schedule (Schedule 5)

3 parts:-

1- centrally reported national requirements (e.g. reporting for the national drug treatment reporting system, 18 weeks where appropriate)

2- locally reported national requirements (e.g. monthly activity and quality reports)

3- suggested priorities for local definition and reporting (e.g. service specific data) plus ‘Data quality improvement plan’

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Mental Health and Learning DisabilityServices Contract

• Schedule 6Service Variations, National variations and other variations

• Schedule 7Managing Activity and referralsEmergency and Crisis Control ProcedureTransfer of and Discharge from Care

• Schedule 8Transition (Regulators registration, Business continuity Plan, DSSA plan) Managing activity and referrals

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Mental Health and Learning DisabilityServices Contract

• Schedule 9Dispute Resolution Procedure

• Schedule 10Provider’s Material Sub-Contractors

• Schedule 11Commissioning Intentions, Service Development and

Improvement Plan (a new plan to drive service improvements in quality), Partnership Agreements (LA), Safeguarding Policy, Surveys and Consortium Agreement

• Schedule 12Serious Untoward Incidents and patient Safety Incidents

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Mental Health and Learning DisabilityServices Contract

• Schedule 13NHS Counter-Fraud and Security Management

• Schedule 14Documents Relied On (e.g. Certificates)

• Schedule 15Change in Control Notification

• Schedule 16Intellectual Property Rights

• Schedule 17Notices

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Local Authority Requirements (Schedule 18)

• Introduction of Schedule 18 Where a local Authority is a party to the contract any specific local requirements should be inserted here.

• Local authority requirements in other parts of contract

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Mental Health and Learning DisabilityServices Contract

• Schedule 19Not Used!

• Schedule 20Clinical networks and Screening Programmes

• Schedule 21Provisions that may be varied (list of

schedules that may be varied by the parties is set out)

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Contract Review & Control

• Remedy before penalty

• Contract reviews

- at least quarterly

- covers service quality, finance and activity, information, contract management issues

• Contract controls

- failure to provide information

- failure to meet service standards

- breach in performance

- suspension and termination

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Contract Performance (Clause 32 and 33)

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Mental Health and Learning Disability Services Contract: what you need to do

• Bilateral or multilateral

• Service specifications

• Activity plan

• Quality requirements

• Quality performance incentive schemes

• Information requirements

• Data quality improvement plans

• Service development and improvement plans

• Social care requirements

Further information

Better Care Better Health Better Life

• All the contracts and their guidance can be found at:http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_111203

• Email queries to :- contractshelp@dh.gsi.gov.uk

or to your local PCT Contract Lead

Thank you and any questions?

Janet Collinson, Assistant Director, NHS Northwest