Clinical Quality and Contract (Provider) Management Support

Challenge

NECS was tasked with delivering provider management and quality support to the North East and North Cumbria Provider Collaborative. This involved:

• New area of policy involving the delegation of specialised commissioning for CAMHS, Adult Secure and Eating Disorders to provider collaboratives (PCs). PCs Taking on a new role as commissioner as well as provider of services for their geographical population (who may be dispersed throughout the country).
• From a commissioner perspective, this involved setting up new contractional relationships across a range of providers within and outwith the host PC geographical area.
• Interpreting national policy and guidance, advising on the appropriate contractual arrangements, including contract type and duration.
• Relationship management with Provider Collaboratives across the country.
• Problem solving and dealing with queries with PCs and NHSE to ensure correct implementation of contracting elements of policy.
• Support to secure innovative new collaborative sub-contracting contract models for the NENC Provider Collaborative to provide contractual governance and oversight for services commissioned
• Quality and Provider Management working to ensure that contracts include all clinical quality requirements e.g., patient safety, clinical effectiveness, and patient experience. Including measurement of patient outcomes, service user/carer experience and any agreed local quality requirements.
• Developing internal systems and monitoring to ensure that specialised commissioning via the Provider Collaborative responds appropriately to, and learns effectively from, a range of information sources including complaints, serious incidents, and patients’ experience of health care across the commissioned providers. This will entail the development of Clinical Quality Review Groups or similar to gain assurance and improve patient care. It will include the development of standard operating procedures and terms of reference.
• Developing oversight of the Serious Incident management and review process by creating a robust process to manage and monitor Serious Incidents, supported by the NHS Patient Safety Strategy, ensuring that the guidelines and principles of the framework are adhered to which will increase patient safety.
• Developing a comprehensive Assurance Visit program, including the development of standard audit tools. This will ensure that service user and carer feedback is obtained and used to improve the quality of services (This will run parallel to the work undertaken by case managers to ensure there is no duplication and that sharing of intelligence takes place).

Tasks

The team led the following tasks as part of the project:

• Interpret national policy and work with customers to ensure compliant contract arrangements are put in place.
• Establish a contract register for all contracts within each pathway.
• Draft and agree Lead Provider sub-contracts for each pathway within and outside of the Provider Collaborative geographical area.
• Identify Lead Provider geography where people are placed out of area and to identify future use of those providers.
• Establish and clarify contractual arrangements with Lead Providers in other geographical areas.
• Set up contract management/assurance processes for each provider collaborative within geographical area. Assurance reports will be issued monthly.