The must read stories and talking points from Monday

Oxfordshire CCG goes again

Some HSJ readers may remember the difficulties Oxfordshire has had developing new forms of contracting for integrated care. These stretch back to 2013, when an attempt to let three big outcomes based contracts collapsed.

We have learned that Oxfordshire CCG, which has an unforeseen deficit and rising demand, is now having another go. The commissioner is knocking heads together after its two main providers failed to integrate care on their own – the contract could involve most community services, urgent care and primary care.

The CCG doesn’t mention new care models overtly, but the multispecialty community provider policy framework is the most useful lens to view this through: as per that document, the CCG has stated a preference for any bids to involve the local GP federations. Cannily, Oxford Health (the local community trust) has announced a plan to set up an MCP and jointly bid with the GPs, potentially isolating the acute trust, Oxford University Hospitals.

Two observations: first – if this is the soil they’re growing the new care model in, should we be concerned that it might be mildly poisonous? And – given rising demand is busting the CCG’s budget, will they be able to persuade a provider to take on the financial risk?

Inevitably we’re reminded of another infamous integrated contract, which collapsed because there wasn’t enough money in the contract to make it work. Hopefully Oxfordshire’s approach to setting up the deal will avoid the elementary traps Cambridgeshire fell into.

MCP maneouvres

On Monday, HSJ reported that Sandwell and West Birmingham Hospitals Trust would probably look to be a lead provider in the region’s powerhouse Modality MCP.

So does this mean the GP led multispecialty community provider has finally decided on its organisational form? Well, no. The powers that be within the vanguard all suggest the form the MCP is to take has not yet been decided.

There are three key providers within this west Birmingham vanguard: Modality, a west Birmingham GP super practice; SWBH and Birmingham Community Trust.

The Sandwell and West Birmingham Hospitals chief executive, Toby Lewis, was clear that in the acute trust must play a key role, but suggested that the local system had not yet committed to developing the MCP form over other models of care such as accountable care organisations or primary and acute care systems.

He was also adamant that any future model could not be possible without collaboration without Modality. A recent What’s in New Care Models briefing explains why GPs must be kept onside.

The need to keep all GPs on board is all the more significant if you consider the Modality MCP’s population coverage. The super-practice covers around 65,000 patients and even if it were to cover 100,000 that would be just half of the west Birmingham population.

There are other notable GP organisations in the area, including the relatively large Your Health Partnership, which SWBH is working with to hire two GP consultants.