Delay Accountable Care Organisation contract, Health Select Committee Chair tells Hunt

Update: 6.2.17

  • The government has confirmed that it will delay “laying” regulations to enable Accountable Care Organisations to operate, until after the NHS England consultation on Accountable Care Organisation contracts.
  • NHS England haven’t said when their consultation on the ACO contracts will happen, but presumably this will be after the 999 Call for the NHS and JR4NHS Judicial Review hearings have happened.
  • The postponement to changing the regulations comes after a massive amount of kerfuffle from Jeremy Hunt in the 23.1.17 Health Select Committee, and an announcement from NHS England that  contracts for the two Accountable Care Organisationpilots in Greater Manchester and Dudley would not be signed in April 2018, as had been planned.
  • Rebecca Thomas, a health Services Journal reporter, tweeted the news:
  • The regulations are the ones the Dept of Health consulted on in Autumn 2017. The Dept of health had planned to make the changes to these regulations this month, by secondary legislation which means doing it without bringing the changed regulation to Parliament for debate and scrutiny.

Original blog post starts here:

The Chair of the House of Commons Health Select Committee, Dr Sarah Wollaston MP, has written to the Secretary of Health and Social Care asking him to

“delay the introduction of the new contract for Accountable Care Organisations until after the Health Committee has taken the opportunity to hear evidence on the issues around the introduction of accountable care models to the NHS.”

The Health Select Committee inquiry into Sustainability and Transformation Partnerships was announced last autumn but put on hold over the General Election period. The deadline for submissions is today, 19th January.  The Committee will be hearing oral evidence in February and March, with a view to reporting after Easter.

999 Call for the NHS is bringing a Judicial Review of NHS England’s Accountable Care Organisation contract on the grounds that its payment mechanism is unlawful.

Geared to meeting the £22bn+ funding shortfall by 2021 that the government is imposing on the NHS in England, the new ACO contract does not link payment to the number of patients treated and/or the complexity of the medical treatment they need, as is required by the 2012 Health and Social Care Act. Instead, payment would be based on a fixed budget for an area’s population.

The contract allows the Accountable Care Organisations to keep any unspent money left over at the end of the year, while also making them bear the risk of overspending.

This new payment mechanism is supposed to drive efficiency and incentivise Accountable Care Organisations to “manage demand” for NHS and social care services, but we’re concerned that financial decisions not clinical need would determine patients’ access to treatment.

This is what’s happened in other countries, where Accountable Care Organisations have cherry-picked treatments and patients that represent “good value for money”, while failing to comprehensively meet patients’ clinical needs.

999 Call for the NHS is currently appealing for £12k to cover the costs of bringing the Judicial Review. Thanks to 381 people who between them have given £9,670 since the appeal launched a week ago, the amount needed has gone down to £2,330.

All donations, large and small, are massively appreciated by all who want #justice4NHS

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