Commissioners have prepared a set of compromises to one of the most ambitious integrated contracting plans after a Department of Health review recommended much closer collaboration with local providers.
The governing body of Oxfordshire Clinical Commissioning Group will vote this week on a set of concessions, which reflect the DH’s recommendations and demands made late last year by Oxford Health Foundation Trust and Oxford University Hospitals Trust.
The CCG will now consider scrapping plans to introduce “outcomes based contracting” for maternity services – one of three service areas it was planning to radically redesign.
It is also proposing to involve local trusts in designing an integrated contract each for older people’s services and adult mental health, and to undertake further work to ensure its plans fit with other local strategies.
The proposals had caught the eye of the DH, Downing Street and Monitor, and were among the most advanced and ambitious integrated contracting plans in the country.
Controversy arose last month after the CCG published a set of business cases proposing going to market to find a lead provider for each of the service lines, prompting Oxford Health Foundation Trust and Oxford University Hospitals Trust to voice opposition.
However, after the trusts spoke out the CCG requested the DH carried out a “gateway review” of the programme, and the contracting plans were paused.
The CCG published the DH report this week. It revealed the commissioning group’s leadership was split on outcomes based contracting, as there was not a “consistent view within the CCG” about how to progress with the scheme. It also confirmed there was also a lack of support for the plans as expressed late last year from “key external stakeholders”.
The CCG had originally proposed to go to tender early this year and award the contracts in July. The DH review said this original timetable for introducing outcomes based contracting was “unrealistic”, but found there was widespread local support progressing with outcomes based contracting in a “well managed way”.
It recommended the CCG involved the local acute provider, Oxford University Hospitals Trust, and the community and mental health trust, Oxford Health, in the contract design – something the CCG agreed to do late last year after the providers first raised objections.
The DH also said that 2014-15 should become a “transitional year”, and that “piloting work… could be carried out with the agreement of all involved.”
Stephen Richards, chief executive of Oxfordshire CCG, is proposing to accept all the recommendations. It will reconsider the feasibility of an outcomes based contract for maternity services as there is “insufficient consensus about the benefits of the approach with the main provider”.
It is also proposed that the CCG collaborates with existing providers, and only revert to going to tender if this proves unsuccessful.