1. Considerations for Current and Future Contracting of the NHS Health Check Programme 17 th July 2012

2. Workshop Panel Members  Jamie Waterall – NHS Health Check Programme Manager – NHS Diabetes and Kidney Care  Rumku Basu-Owen – Team Leader Public Health Commissioning - Public Health Policy and Strategy Unit  Janet Collinson – Assistant Director of Finance (Contracts) – NHS North West  Mark Smith – Primary Medical Care Branch – Department of Health Commissioning Development Directorate  Dharminder Khosa – Public Health Category Manager – Nottinghamshire County Council

3. Better Care Better Health Better Life Contracts Transition Update NHS Health Check Learning Network 17th July 2012 Janet Collinson NHS North West janet.collinson@northwest.nhs.uk

4. Better Care Better Health Better Life Current Position Stocktake complete (data capture tool) Stabilise – Guidance issued Shift – Guidance awaited Timeline

5. Better Care Better Health Better Life PCTs are responsible for preparing the ground by taking action that will enable the smooth transfer of clinical contracts to the receiving contracting bodies at 31 March 2013 / 01 April 2013. Receiving contracting authorities are responsible for fully engaging during the forthcoming contracting round to ensure the smooth transfer of contracting arrangements and the transfer of corporate memory.

6. Better Care Better Health Better Life Key stabilisation activities are: Keep the contracts information on the data capture tool up to date. Routine monitoring of any significant discrepancy between the financial reconciliation and the data capture tool totals. Develop Contracts Transition Engagement Plan to support the provider community to understand the contract transition process. Develop and implement a Stabilisation Action Plan detailing mitigating action to be taken to address the key risks across each type of contract. Ensure there are clear priorities for action, prioritised according to the level of risk.

7. Better Care Better Health Better Life Action set out in the Stabilisation Action Plan and Engagement Plan should be complete by end September 2012. Where agreements do not exist in writing or cannot be located commissioners may wish to consider formalising the existing arrangements in a written form. (Note: Commissioners should be mindful of the potential procurement risk or challenge as this will be viewed as a new contract even if the documentation formalises an existing arrangement). PCTs may wish to consider an appropriate archive process for contracts that expire prior to 31 March 2012 as there may be on- going liabilities and terms that survive expiry or termination.

8. Better Care Better Health Better Life By the end of September 2012 PCTs are expected to be able to provide a full list of all clinical contracts (primary care, specialised services, other contracts and including ‘enhanced services’, grants, and partnership arrangements) The level of detail is likely to be Sending organisations details (PCT name, address etc.) Provider name, address etc. Brief services description Receiving organisations details (all relevant CCGs, NHSCB, relevant LA) Further guidance will be issued in the autumn to support PCTs with the ‘Shift’ phase of the contracts transition project

9. Better Care Better Health Better Life Health and Social Care Act 2012 s.300 in essence says: There are two types of transfer schemes Staff transfer schemes Property transfer schemes (includes contracts) Things that can be transferred include: property, rights and liabilities that could not otherwise be transferred; property acquired, and rights and liabilities arising, after the making of the scheme; criminal liabilities

10. Better Care Better Health Better Life Currently the standard methods that contracts are transferred by are: –assignment (transfer of the benefit of a contract); or –novation – a three-way agreement between the existing parties and the incoming party, who ‘steps into the shoes’ of the outgoing party. The Health and Social Care Act 2012 removes the need for transfer by these means – transfer of PCT contracts will occur automatically (‘by operation of law’). - Transfer Orders. From 1 April 2013, PCTs’ place in existing contracts will be taken by other service bodies (Property Transfer Schemes covers all property, rights and liabilities of the PCT, even those ‘that could not otherwise be transferred’ (so, for example, contractual restrictions on transfer will not stop the automatic transfer). All continuing liabilities of PCTs must be ‘mopped up’ and transferred to an appropriate body). The process mirrors the approach taken for other Government reorganisations.

11. COMMISSIONING DEVELOPMENT DIRECTORATE Contracts Transition & Enhanced Services NHS Health Check Learning Network 17th July 2012 Mark Smith Department of Health mark.smith@dh.gsi.gov.uk

12. COMMISSIONING DEVELOPMENT DIRECTORATE Contract transition  Contract transition work applies equally to local enhanced service agreements: Stocktake – PCTs now asked for a detailed list of all enhanced service agreements by end of September. Stabilise – identify key risks and take mitigating actions, formalise contract documentation etc. Shift – agreements overhanging 31 March will transfer via national transfer orders.  But some unique risks and issues to face…

13. COMMISSIONING DEVELOPMENT DIRECTORATE Issues (1)  Many local enhanced services are 1-year agreements: decision to extend or re-procure services? If so, how will you achieve that as existing commissioning powers apply? As existing contract holders PCTs not expected to act in isolation of local authority requirements. APPROACH NEEDS TO AVOID PROCUREMENT RISK OR CHALLENGE.

14. COMMISSIONING DEVELOPMENT DIRECTORATE Issues (2)  LES transfer as local authority contracts: Only the NHS Commissioning Board can use enhanced service contracts – they are a subset of the GP contract vehicles.  To naked eye this will not be a visible concern – content of the LES agreement transfers: Service specification and terms for monitoring, payment, duration and termination all transfer (if included in the agreement).  But…transferred agreements may not provide sufficient terms and conditions to protect against wider risks/issues: Under LESs PCTs and providers fall back to the core GP contract. What [contracts] will local authorities use? A model public health contract is being developed.

15. COMMISSIONING DEVELOPMENT DIRECTORATE Next steps  What risks can you identify and how will you manage these? NHS Health Check agreements due to expire by 31 March 2013.  Extend, Re-procure?  In-house provision? Contract vehicle for NHS Health Check services from 1 April 2013.  Existing agreements sufficient?  Adopt local authority or model public health contract?  How avoid procurement risk and challenge from any changes?  What questions do you need answers to?

16. Keeping the Ship Afloat, or Setting Sail? NHS Health Check Learning Network 17th July 2012 Dharminder Khosa Public Health Category Manager dharminder.khosa@nottscc.gov.uk

17. It all started when I bumped into an old colleague in reception at County Hall… The story of a transition into a Local Authority

18. Meeting in reception Who is looking after Public Health? A bespoke service offering to welcome you in Public Health Transition

19. Keeping the Ship Afloat – Transacting Public Health Transition

20. Keeping the Ship Afloat – Transacting How will Public Health instruct activity? How will Public Health record delivery? How will Public Health authorise payment? Public Health Transition

21. Prepare for the journey – Contracting Public Health Transition

22. Prepare for the journey – Contracting What terms and conditions of trading will apply? How will contracts ensure legal compliance? How can we demonstrate value for money? Public Health Transition

23. Setting sail for the voyage – Procurement Public Health Transition

24. Setting sail for the voyage – Procurement What are the current arrangements for Healthchecks provision? GP only or mixed? If GP only, do we need to rock the boat? If mixed providers, has the opportunity been fairly competed? Decide on your procurement strategy (AQP / Restricted / Single tender etc.) and navigate your way through the risks! Public Health Transition

25. And if you need assistance – help is at hand Public Health Transition

26. And if you need assistance – help is at hand Local authority procurement teams NHS Commissioning Support Services CCG Collaborative Commissioning Independent Commissioning Support Organisations Interim/Perm Procurement and Contracting Professionals Public Health Transition

27. Keeping the Ship Afloat, or Setting Sail? Dharminder Khosa Public Health Category Manager dharminder.khosa@nottscc.gov.uk

28. Panel Questions & Discussion