CSUs required to offer outcomes based contracting support

NHS England is inviting bids for accreditation to its lead provider framework for commissioning support services from today. When the system goes live, something which is scheduled for January 2015, the framework will enable customers to choose between a range of accredited, quality assured, “end to end” providers.

Today marks the launch of the pre qualification questionnaire stage of the process. Bidders have 11 weeks to draft their bids, and NHS England will announce which organisations have been successful in July.

The invitation to tender stage will follow, lasting from July to November, and successful providers will be announced at the beginning of 2015.

• Why CCGs need greater choice of support services

Full details of the pre-qualification questionnaire will also be published today. Bob Ricketts, NHS England’s director of commissioning support strategy and market development, told HSJ that prospective bidders would be required to demonstrate that they could offer radical contract redesign services to their customers, either directly or through partnering.

The example given will be outcomes based contracting – an alternative to the conventional payment by results system – in which providers are paid based on improving clinical outcomes rather than activity.

Mr Ricketts argued that the framework enabled NHS England to manage what was “still an emergent market”, and to force support service providers to improve.

“You don’t want the framework to fossilise current commissioning practice,” he said. “We are looking to set the standard really high because we want this to drive up standards of commissioning support.

“We don’t want to replicate current good practice – we’re going after best and emerging practice. We’re expecting providers to demonstrate how they can do innovative commissioning… the transformational, what’s coming over the horizon.”

Mr Ricketts is an outspoken advocate of outcomes based contracting, particularly in the form offered by the COBIC consultancy, which is working with Oxfordshire Clinical Commissioning group on its plans, as well as other areas.

NHS England hopes the lead provider framework will be the first choice for CCGs wishing to procure support services or change their supplier. If CCGs do widely adopt it, it will be worth an estimated £3bn to £5bn over five years, based on an annual market value of between £500m and £1bn.

Although there are currently 17 CSUs, arranged into nine groupings or partnerships, there will 30 places on the framework available for potential suppliers to begin with. NHS England expects some CSUs may be part of more than one bid, and is keen to encourage bids from private providers or charities. Mr Ricketts said he expected to see some “attrition” in the number of bidders throughout the process.

Mr Ricketts would not say how many slots there would be on the final framework, previous NHS England guidance has suggested there will be 10 to 15.

He has previously said that any CSUs which failed to win accreditation to the framework, either on their own or as part of a joint bid, will not be autonomised.

The framework will be available to any public sector body, meaning that NHS providers, councils, and regulators will be able to use the framework to procure support services, as well as NHS commissioners.

Separate to the lead provider framework NHS England is also planning to establish a “niche and specialist supplier list”.

Mr Ricketts said the intention was to allow smaller companies and charities the opportunity to enter the market without needing to partner with a larger provider.

The niche supplier list will involve only a “light touch” accreditation process and services will not be quality assured.