• STP looking at options to integrate non-clinical support services across providers and commissioners
  • Potential for sustainability and transformation funding to be used to buy out private finance initiative
  • Wolverhampton CCG to set up an MCP alongside existing PACS model
  • Modality MCP to be established from April 2018

The Black Country Partnership sustainability and transformation plan has said it is looking at options to integrate non-clinical support services across both commissioning and provider organisations.

The document, published today, also said it could use sustainability and transformation funding to buy out expensive private finance initiatives and local improvement finance trusts.

It said: “There may be opportunity to leverage the £3.8bn sustainability and transformation fund on a non-recurrent basis, to buy out elements of PFI or LIFT.

Addressing the idea of working at scale between provider and commissioning organisations, the STP said “there is significant potential to integrate the non-clinical support services across both provider and commissioner organisations” with some services consolidated as early as 2016-17.

It said the greatest potential for savings would be in payroll, support staff employment models, procurement, human resources, telephony and legal services, call centres, licensing of telephones, IT applications and hotel services.

Options for delivering these non-clinical support services include commissioning support units delivering services for both commissioners and providers, the creation of a new entity owned by providers and commissioners, and the use of multiple providers to deliver services.

However, the document said that CCGs have recently signed contracts with their commissioning support providers, which may impede or delay plans to consolidate.

“Consolidation may require termination payments, degrading the value for money case,” it added.

The STP also suggested CCGs could share functions with NHS England and the Care Quality Commission. “As CCGs evolve to maximise their future effectiveness, it will also be important to consider opportunities for integration of some functions with the regulators, particularly NHS England and the Care Quality Commission, such as service assurance activities,” it said.

The need for £34m capital investment in primary care premises was also identified in the document, with a further £16m to “support the provision of services closer to patients’ homes”.

According to the STP, Sandwell and West Birmingham Clinical Commissioning Group hopes to fully establish the Modality multispecialty community provider by April 2018 and have others take on this new care model a year later.

Wolverhampton CCG will likely turn to an MCP model in 2017-18 to deliver its community services. This is despite the CCG having already established a primary and acute care system type model with the Royal Wolverhampton Trust and a primary care home model with a local GP federation.

Regarding the spread of new care models in Wolverhampton, the STP said: “Wolverhampton’s primary care strategy is underpinned primarily by delivery through a multispecialty community provider delivered by care hubs who are supported by integrated teams and through a primary and acute care system…

“As we move into contracting year 2017-18, it is likely that an alliance type MCP contract will become the vehicle through which [Wolverhampton CCG’s] community delivered services are commissioned.”