Primary care trust clusters will have to complete a detailed stocktake of their 75,000 service contracts by the end of March 2012, in preparation for transferring them to successor commissioning bodies the following year.
In a letter circulated to PCTs and strategic health authority clusters today, deputy NHS chief executive David Flory said that ensuring a smooth transition would be one of their “key responsibilities” during the period of transition to the new NHS structure.
The letter suggests that some contracts are currently inadequately documented. PCT and special commissioning group clusters will have to “address actions in the deficiency of documentation and management controls so that agreements can be transferred”.
The DH was unable to explain whether clinical commissioning groups or the NHS Commissioning Board will take over the contracts. The letter does not specify what will happen where a CCG is not authorised or is only partially authorised.
Mr Flory estimated that there were 75,000 clinical service contracts or agreements in place, and the stocktake is intended to account for 100 per cent of the healthcare service spend.
Clusters will have to identify, locate, “profile”, and risk assess contracts in two stages. The first part of the stocktake will have to be completed by 31 January 2012, and will include primary medical care, dental services, pharmacy, diagnostic services and individual patient agreements.
The remainder of the stocktake must be completed by 31 March 2012, and will cover acute, mental health, community and ambulance services.
A “stabilise” phase will address any problems highlighted by the stocktake, including notifying providers of any necessary changes in contract documentation.
Clusters will have to decide which changes can be brought in through normal contract variations, through 2012-13 agreements, and in exceptional cases, through 2013-14 agreements.
A final “shift” phase will complete the transfer of contracting responsibilities.
The Department of Health has issued a toolkit setting out in detail how the stocktake is to be carried out. Further guidance on the stabilisation phase will be released later.
NHS Confederation head of commissioning policy and membership Elizabeth Wade said PCTs were working hard to ensure all documentation is ready to hand over to successor bodies. She said: “This is just one part of the very significant workload they are managing at the moment which includes preparing the ground for the new commissioning structures while continuing to manage their existing day to day commissioning and contracting responsibilities.”
Foundation Trust Network chief executive Sue Slipman said contracts should transfer to CCGs in the form that they were originally agreed. She pointed out that providers would have to deal with more contracts in future as there were likely to be more CCGs than primary care trusts, while some CCGs would not be authorised initially.
She highlighted the risk to providers of significant changes being made to contracts. “This isn’t an opportunity to reopen negotiations that have already been undertaken… it’s already a riskier process the more parties you get engaged who weren’t involved in the original negotiation,” she said.
“What you don’t want is throwing provider organisations into utter chaos and undermining their stability and risk failure.”