Exclusive: Second ACO contract delayed amid fears of 'unrealistic deadlines'

Manchester Health and Care Commissioning – a partnership created by Manchester Clinical Commissioning Group and Manchester City Council – had hoped to award a new £6bn contract to a consortium of community providers in April.

However, minutes of a committee meeting leaked to HSJ reveal various concerns were raised about the timeline, with senior figures describing it as “unrealistic”.

An MHCC spokeswoman told HSJ a “local care organisation” formed between the group of providers, including Manchester University Foundation Trust, the council and local GP federations, will still go live from April. But she confirmed services will be provided through “existing contracts and partnership agreements”.

HSJ revealed in October how plans to make the LCO a distinct legal entity had to be scaled back due to VAT and legislative issues. At the time, it was thought the FT would need to formally host the contract.

Minutes of the committee meeting, on 15 December, said: “[Gareth James – head of people and place regulation at the council] said there would be merit in discussing whether April 2019 would be a better target date, so no contract to be awarded at this stage but get the LCO established from April 2018 and see how it works on the ground and work through as much of the unresolved issues as possible.

“Mr James said he has been concerned throughout the process that unrealistic deadlines were set. [Chris Harris – the council’s executive director of nursing and safeguarding] partly supported what Mr James said and felt the more conversations he has, the less assured he becomes.”

Sue Murphy, deputy council leader, was quoted saying: “We did set a deadline of April and it is clear we are not going to achieve it – not sure whether six months or 12 months [later] is right until we know what the timeline is going to be to get to the next stage.”

The minutes also warn that Manchester’s plan could be brought into a judicial review launched against NHS England’s contract for accountable care organisations.

A spokeswoman for MHCC declined to comment on the concerns raised in the minutes, but said: “Our focus for the LCO – which will go live from this April – is around improving health outcomes for the people of this city and that is the priority for everyone involved.

“Due to extremely complex VAT and other external issues, which will take some additional time to resolve, we will use existing contracts and partnership agreements while discussions continue about future contractual arrangements.”

Earlier this month, HSJ reported that Dudley CCG had to delay awarding its ACO contract by seven months and will not launch its model until 2019. It had planned to award the contract in April 2018 but this has been pushed back to November.