Commissioners and providers seek move to long-term contracts

Forum chair Steve Field told HSJ today that the group’s listening exercises had revealed a widespread desire to “break free” from the current annual planning cycle, based around one-year contracts.

Stressing that the forum’s final report has not yet been written, he said: “One of the suggestions that comes up time and time again is that we need to think long term, looking beyond spending reviews [which the government carries out every three or four years].”

The forum has been told that the tariff should be linked to long term contracts, “certainly longer than five years”, he said. “People want a fundamental shift towards long-term planning,” he told HSJ.

Longer contracts would enable NHS bodies to work together to plan the services they offer over a longer period of time, but could still have enough flexibility built in to allow providers to adapt to new clinical developments and emerging demands.

Professor Field said the forum was hearing a “plea” for longer contracts “from patients, commissioners, and providers”.

Last week a deal was signed allowing private firm Circle to run Hinchingbrooke Health Care NHS Trust for 10 years.

Professor Field added that the forum held a “very constructive” meeting with Monitor this week, in which he said he found the regulator in “listening mode”, and “very supportive of the things we have been putting to them”.

“I believe they are getting a better grasp of what collaboration and integration means”.

His remarks come after the forum published an open letter to health secretary Andrew Lansley, calling for “flexibilities” in the payment by results tariff. That letter was intended to influence the NHS Operating Framework, set to be brought out on 24 November.

HSJ has already heard that the Department of Health is planning to move away from payment by results to more “bundled” contracts in 2012-13.