NHS providers have called for clarification about who will arbitrate in contract disputes with commissioners once strategic health authorities are abolished.
They fear the NHS Commissioning Board, which many perceive is likely to be biased towards commissioners, will make critical decisions on funding.
In the past, SHAs – seen to be neutral – have been the formal arbitrator in disagreements, and also often been informally involved in resolving disputes between providers and commissioners.
Planning guidance published by the commissioning board last month says that its 27 local area teams “will be responsible for tracking progress on the negotiation of contracts for CCG-commissioned services and [its] regional offices will have oversight of contracts for the NHS CB’s directly commissioned services”.
It says: “It is expected that disputes will be exceptional. Where they do occur… The NHS CB will work closely with Monitor and the [NHS Trust Development Agency to ensure that consistent messages on contracting are received by commissioners and providers.”
Contracting guidance for 2013-14, also published by the commissioning board last month, says that in formal disputes between either the board itself or CCGs and NHS trusts, there would be “mediation arranged jointly by the [NHS Trust Development Authority] and the NHS CB”.
Where the provider is a foundation trust or independent provider, they will nominate an independent mediation body - generally the Centre for Effective Dispute Resolution.
Foundation Trust Network chief executive Chris Hopson called for more clarity on the arbitration process. He said it should involve representatives of providers as well as commissioners.
He said: “There are bound to be cases where unfortunately commissioners and trusts disagree. It is very important both commissioners and providers are represented [in the arbitration process].
“There is a degree of nervousness on the provider side that LATs are seen as the only player.” He said the commissioning board was “bound to take the commissioner point of view”.
A large hospital trust’s finance director said providers were particularly concerned about arbitration for 2013-14 as CCGs and commissioning support units, in their first year in control, may be keen to demonstrate their strength by cutting spending.