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ACSs lead the way for STPs

The first NHS “accountable care systems” must develop a “pathway” for STPs in other areas to follow, according to their agreement with NHS England, seen by HSJ.

Details of the benefits for and requirements of the first eight ACSs are revealed in the memorandum of understanding they have signed with NHS England.

It has not been published but a draft version said there will be a “development group” of the eight ACS leaders and NHS England and I directors, which will “develop a pathway to full ACS status and learning for other STPs to follow”.

“National bodies and initial shadow ACSs will work together to spread this learning to other STPs,” the agreement says, and adds that “learning can be made available to ‘fast followers’”.

Many STPs were generally accepted to have struggled to develop strong shared plans during 2016. They have continued to be developed – particularly on delivery plans for 2017-19, in recent months. Performance information and potentially ratings are due to be published soon.

The draft MOU also sets out stringent quality, finance and governance demands on the eight current ACS areas.

These must be met during the 2017-18 “shadow” year, with a final “joint decision” to be made between NHS England and each ACS by February 2018 at the “latest” about whether it can adopt “full ACS status” for 2018-19.

Contract dispute revealed

NHS England attempted to keep secret the loss of a contract dispute with a teaching hospital trust, fearing it would encourage other challenges.

The national body has refused to publicly disclose the names of two organisations that took it through an arbitration process over their 2017-18 and 2018-19 specialised services contracts.

However, internal emails seen by HSJ reveal Brighton and Sussex University Hospitals Trust won a challenge against the national commissioning body over £6m in payments.

In one of the emails, an NHS England senior communications consultant, writing to a solicitor, said: “There is a risk that if other trusts find out that the arbitrator found in favour of Brighton’s challenge it could lead to other trusts to be more ready to go to arbitration.”

For the first time, commissioners and trusts negotiated a contract for two financial years at the end of 2017, covering 2017-18 and 2018-19.

NHS England was keen to present this as a success after the provider rebellion against the 2015-16 tariff, which created a two-tier system with some trusts on the new tariff and others staying on their previous arrangements.

It is not known which other trust took NHS England to arbitration, over which contract and what the result was.


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