• One of the first ‘ACO’ contracts to be let
  • Foundation trust was the only provider to express an interest
  • Due to begin in April next year

A northern foundation trust will take control of a single budget for all local services except primary care from next April in a significant step forward for the new care models programme.

Northumbria Healthcare Foundation Trust has confirmed that from April 2017 it will hold a single contract for acute, mental health, community services and adult social care services, establishing a “partially integrated” primary and acute care system.

HSJ has learned that Northumberland clinical commissioning group issued a prior information notice to alert the market that a new contract for the service will be let from next year. The PIN closed on 26 September, and Northumbria Healthcare FT was the only provider to express an interest in running the service.

Local leaders have confirmed the new model of care will be run by an “accountable care organisation” board. A Northumbria Healthcare spokeswoman said the ACO would be a “partnership of the key health providers”, hosted by the trust.

A policy document published this week by NHS England said the vanguard site was one of two likely to go for partial integration next year, while a third PACS site, Mid Nottinghamshire, has already entered into a “virtual integration” arrangement via an alliance contract.

None of the PACS vanguards are yet ready to become “fully integrated”, where a single provider holds a single budget for all local services including primary care. This means there will be no fully fledged PACS providers until 2018 at the earliest.

The national new care models team is developing a template PACS contract. However this is not currently expected to be published until summer 2017.

Although Northumbria Healthcare will be the formal budget holder, it will not directly provide all services within scope of the contract. For example mental health services would remain provided by Northumberland, Tyne and Wear Foundation Trust. HSJ was told the contract and funding for these services would be coordinated by joint “ACO board”, which both trusts will sit on.

A trust spokeswoman said arrangements for primary care and specialised services commissioned by NHS England would not change. Although Northumbria Healthcare runs a small number of local GP practices, almost all in the region are independent of the trust “and will remain so”.

This means that if Northumberland wishes to move to a fully integrated model, the trust will either have to subcontract primary care services to local practices, or set up a new organisation such as a community interest company or limited liability partnership with GPs to act as the PACS.

HSJ understands GPs are considering five possible options to enable them to be jointly represented on the accountable care organisation board. These include a memorandum of understanding covering all practices, a federation and a joint venture company. Local GPs will discuss these further this October.

Northumberland’s new model of care will serve a population of around 320,000, covering the Northumberland CCG population but not Northumbria Healthcare FT’s full catchment area.

Contract to be let for pioneering 'ACO'