• NHS Improvement finance chief calls for “really strong push” in contract negotiations over next few days
  • Bob Alexander says progress has been made since national bodies issued new deadlines for contract offers earlier this month
  • Still not “sufficient contracts formally agreed”
  • Contracts unsigned after 25 April enter arbitration process

NHS Improvement’s finance chief has said the health service needs another “significant push” over the next four days to get 2016-17 contracts agreed before arbitration kicks in on 25 April.

Speaking exclusively to HSJ, Bob Alexander said it was clear that progress had been made since NHSI and NHS England called upon the NHS earlier this month to renew efforts to resolve contract disagreements.

Bob Alexander

Bob Alexander

Bob Alexander: ‘We don’t have sufficient contracts formally agreed’

The NHSI executive director of resources said more contracts had now been agreed and the gaps between commissioner and provider positions were narrowing.

However, he added that the service still did not have “sufficient contracts formally agreed” and it needed a “really strong push” from commissioners and providers over the next few days to “either finalise definitively or get closer to agreement”.

The contract round for 2016-17 has proven very difficult and few contracts were agreed by the 31 March deadline. Contracts that remain unsigned after midday on 25 April will be placed into formal arbitration proceedings.

Earlier this month, NHS England and NHS Improvement gave commissioners a deadline of 8 April to issue “reasonable” offers to all of their providers. Providers were given until 13 April to issue counter-offers.

In a letter sent to chief executives on 6 April, Mr Alexander said there was a “significant gap” between commissioner and provider positions across clinical commissioning groups and specialised commissioning; some commissioners had still not made offers; and others had made offers that “do not appear to be a reasonable basis for negotiation”.

Speaking to HSJ on Wednesday, he said that NHSI’s latest intelligence was that there were now more contracts agreed and the remaining gaps were narrowing.

However, he added: “I will want to know that contracts have been formally signed. When contracts are formally signed then I will know that we have resolved [the situation].

“What I can say currently is we don’t have sufficient contracts formally agreed, but what we do have is a lot of work that indicates… differences are coming closer together and there are fewer differences.

“We’ve just got to get behind people now to continue the efforts they’ve made, so that we get to 25 April in the best position we possibly can.”

Asked if he was confident there would not be significant numbers of contracts in arbitration, he said: “I personally think we will have some arbitrations to deal with. I hope they are not significant.” He added that the progress made this month suggested many people were “doing their best to avoid that”, but if the national bodies needed to use arbitration “we will use it”.

Asked if he thought contracts with NHS England’s specialised commissioners would be signed by the deadline, he said: “There’s an awful lot of work that’s been going on between [NHSI and NHS England] about trying to resolve the particular challenge that specialised providers and specialised commissioners seem to have had. That’s working to the same timescale. I sincerely hope the amount of work people are putting in is going to get us to a good place by the 25 April.”