HSJ’s round-up of Friday’s must read health policy stories

The future starts now

An important moment for new care models – Dudley has become the first multispecialty community provider vanguard to set out how it plans to go about setting up the new type of provider, and reveal details of what sort of organisation it might be.

The first revelation is that they are going to procure the MCP, via a competitive dialogue process. CCG governing body papers reveal there was no way of letting a new contract of this size without an open procurement process.

What size? Order of nearly £250m a year for 10 to 15 years. The deal would cover primary care, mental health, outpatients and community services. Social care isn’t included yet, but might be later. There will be outcomes based incentives for, for example, avoidable accident and emergency admissions. It will bite a chunk worth about £80m out of the local acute services contract.

The Dudley documents also reveal they will be awarding the MCP contract to a single legal entity, capable of holding a large contract and managing significant financial risk. In Dudley, the MCP will not mean an “elaborate alliance contract” – it will be a provider organisation, which might subcontract some services to other local providers.

What sort of organisation the MCP will turn out to be isn’t entirely clear: Dudley are not saying it has to be an NHS trust, or private provider, or that it must be GP led, for instance. However, it must have transparency and governance arrangements “consistent with” a public body.

The contract is supposed to be signed by April 2017, and fully mobilised by 2018. That gives us a best case scenario for the adoption of a new model of care in one of the most advanced vanguard sites.

Dudley is just one MCP. Others may adopt a different approach, or go slower, or take a more cautious tactic to begin with. But the point of new care models is that they are widely applicable, so this detail tells us a significant amount about how the move to MCPs will work nationally.

Look out for NHS England’s board papers later this month, where we expect a major policy document on MCP and primary care contracting to be published.

Clean up job

While many people were distracted by Theresa May’s cabinet reshuffle on Thursday (which brought no change in personell for health), Jim Mackey was continuing his no-holds-barred assessment of the NHS’s challenges.

Following his HSJ interview on Wednesday, at NHS Improvement’s conference the chief executive told senior managers the health service is “in a mess”, in another stark warning on finance and performance issues.

He said there had been “five years of decline on all of the things that people would worry about”, and underlined that accident and emergency performance was a major focus for the service over the coming year.

But Mr Mackey also called for leaders to be more upbeat, saying: “We have to change this narrative, and focus on what’s positive and put outselves back in control of the work.”