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Practice Based Commissioning Agreement Between Kirklees PCT and xxx Commissioning Consortium May 2008

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Document date 9 May 2008


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CONTENTS 1. Introduction 2. Principles of Agreement 3. Obligations of the Primary Care Trust 4. Obligations of the Practice Based Commissioner 5. Governance − Financial − Corporate − Clinical 6. Monitoring and Communication 7. Termination of Agreement 8. Arbitration

Acknowledgments: Sources used in the production of this document were: British Medical Association, 2007 “Practices’ entitlements and PCTs’ responsibilities in respect of Practice Based Commissioning 2007-08” Doncaster Primary Care Trust, 2006 “Practice Based Commissioning Agreement”


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1. Introduction This agreement sets out the basis for the relationship between Kirklees Primary Care Trust (the PCT) and XXX Practice Based Commissioning Consortium (the Consortium). The purpose of this agreement is to ensure the effective implementation of Practice Based Commissioning (PBC) in Kirklees for the maximum benefit of the registered population.

2. Principles of Agreement The following principles underpin the relationship between the Consortium and the PCT: z

z

z

z

z

z

Working Together to meet National Targets and Local Priorities in one System of Commissioning The Consortium and the PCT will ensure that the services commissioned meet national targets and agreed local priorities based on local health needs Effective Partnership Working The Consortium and the PCT will work as partners in developing commissioning strategic plans. This will include the consortium and the HITs working in partnership. This partnership approach will facilitate working with a wide range of statutory, independent and voluntary sector providers through clarity of responsibility Sharing Commissioning Tasks The Consortium will include clinicians and non-clinical members of the practice team in commissioning decisions and recommendations. The PCT will take forward agreed recommendations and carry out transactional elements of commissioning such as agreeing contracts and negotiating contractual performance with providers. Involving Patients and the Public The Consortium and the PCT will work within the Kirklees Patient and Public Involvement (PPI) strategy. The Consortium and the PCT will ensure appropriate opportunities for patients and the public to be involved in informing commissioning decisions. Promoting and Supporting Innovation The Consortium and the PCT will encourage and support care pathway redesign where this delivers national and local targets. The PCT and the Consortium will consider proposals for service change and, where appropriate, support developments with the aim of extending services that prove effective. Achieving Financial Balance The PCT has a statutory duty to achieve financial balance. This is recognised by the Consortium who will operate within their allocated budget.


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z

z

z

•

Risk Sharing The Consortium and the PCT will work together to manage financial risk by agreeing a contingency fund and commissioning high-risk areas such as specialist services on a PCT-wide basis. Implementing Robust Governance Arrangements There is a statutory requirement to demonstrate public accountability for the use of public money. This includes a requirement to identify potential conflicts of interest and declare them in advance. This applies equally to the Consortium, constituent practices and the PCT. Further, to achieve value for money the consortium and PCT will evaluate all developments. Sharing Good Practice The Consortium and the PCT wish to ensure that examples of good practice are shared and that learning is taken from all new initiatives. To assist this, business cases and other documents produced by the Consortium will be shared with other consortia/practices and business cases and other relevant documents from other consortia will be shared with the Consortium. Ensuring Sustainability The Consortium and the PCT wish to ensure arrangements that are stable and sustainable. To this end any practice wishing to join or leave a PBC consortium will be enabled to do so only at the end of a financial year in preparation for the following financial year.

3. Obligations of the Primary Care Trust In implementing the principles of the agreement the PCT will: z

z

z

z

z z z z z

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Ensure that the Consortium is a fundamental part of commissioning arrangements, promoting a partnership approach in one system of commissioning. Give appropriate consideration to the Consortium’s recommendations in making service procurement decisions Provide high quality managerial, administrative and technical support to the Consortium via PCT employed staff. This will include PBC Commissioning team, PBC Finance team, Performance and Information team, Medicines Management team and administrative support Provide accurate, useful and timely information on which to base commissioning recommendations Provide public health information on health needs Provide research evidence of clinical and organisational effectiveness Undertake service outcome monitoring Develop mechanisms for patient and public involvement Provide funding for Consortium costs through a PBC Management (Clinical Engagement) allowance. The first call on any freed up resources will be paying back this allowance. Enable the Consortium to access at least 70% of any freed up resources (following deductions for management (clinical engagement) allowance,


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z

z

z

contingency fund and PBC business cases relevant to the consortium or any of their constituent practices) subject to approval of business cases. Freed up resources made in one year will not be deducted from future indicative budget allocations. Freed up resources are assumed to be nonrecurrent and business cases for the use of freed up resources should reflect this. In accordance with national guidance, resources freed up must be used to fund services for the benefit of patients locally. Resources freed up may be spent on equipment, training, clinical and non-clinical staff. They may also be spent on premises development with specific PCT board approval. The PCT retains responsibility for the procurement of new services from freed up resources. Operate a Board sub committee to be responsible for assessing the Consortium’s business cases with a published cycle of meetings to enable the prompt assessment of these cases. Provide a local incentive scheme for Practice Based Commissioning that recognises effort and rewards results. Money earned by the practices of the Consortium will be individual practice income Avoid contracts with providers for new services that set any level of guaranteed income/ payment or activity/volume

4. Obligations of the Consortium In implementing the principles of the agreement the Consortium will: z

z z

z z

z z

z

z

z

z z

z

Work in partnership with the PCT in making progress towards strategic objectives Recommend the commissioning of high quality services Demonstrate sufficient commissioning capacity and capability to influence redesign of care pathways Engage patients and local communities in the commissioning process Include front line staff in the commissioning process, for example involving community nursing teams in the commissioning of long term care Plan the use of resources so that its budget breaks even Work in partnership with the PCT in reducing health inequalities in access to services Review and develop services in partnership with clinicians, providers, managers and service users Work within a framework for reporting and accountability agreed with the PCT Work within locally agreed protocols for information sharing between partner organisations Participate in the Kirklees Commissioning Forum Work jointly with the PCT by enabling designated PCT staff to participate in Executive meetings and plenary sessions as partners Participate as a partner in a two way annual review of PBC involving designated PCT Directors, Non Executive Directors and PEC members


18/07/200815:41 National guidance on Practice Based Commissioning sets out the responsibilities that will rest with the Consortium in taking on an indicative commissioning budget on behalf of practices and these include: z

z

z

z

Ensuring that patients exercise choice at the point of referral where appropriate Ensuring plans fit with national and local targets or priorities identified in the Vital Signs and Existing Commitments and Strategic Commissioning Plan. Ensuring that any clinical changes made do not adversely affect health inequalities as identified by the Department of Health priorities, based on Public Service Agreement (PSA) targets (these include improving the health of the population, supporting people with long term conditions, access to services and patient/user experience) Reflecting pre-existing PCT agreements in their commissioning choices – these include agreements with the Foundation Trusts and Section 31 arrangements (pooled budgets with Social Services)

5. Governance The PCT and the Consortium will operate within national guidance (including that of the Department of Health, the General Medical Council and other professional bodies) and local arrangements for financial, corporate and clinical governance. The Consortium will: z

z

z z

z

z

Be responsible for delivery of a PBC Commissioning Plan agreed with the PCT Regularly review the costs and benefits of services in order to be clear about how and why changes to services are being recommended Be accountable for the outcomes of its commissioning proposals Engage in wider planning activities with the PCT so that Consortium activity is consistent with overall priorities Ensure that recommendations for the use of freed up resources are consistent with national PBC guidance Regularly and effectively engage with service users to ensure that future commissioning recommendations reflect patients’ experience

The PCT will: z

z

Work with the Consortium to develop a rolling three year PBC Commissioning Plan, concurrent with the PCT’s Strategic Commissioning Plan, which will extend the scope of the Consortium’s indicative budget towards comprehensive inclusion of all services Undertake regular reviews of PBC and raise with the consortium, as a matter of urgency, any commissioning activity or behaviour that is giving cause for concern


18/07/200815:41 z

Review all submitted commissioning/service redesign proposals through the Business and Financial Planning Forum and make recommendations to the Board for approval

6. Monitoring and Communication The Consortium and the PCT will ensure that communication between them is excellent. As well as designated PCT representation on the consortium’s Executive Committee, regular review meetings and reports to the PCT’s Professional Executive Committees will be included.

7. Termination of Agreement This agreement will commence on 1st June 2008 and will be subject to annual review. Either party may end the agreement on 31st March in any year subject to three months prior notice.

8. Arbitration The essence of successful PBC is in the PCT and practices working in partnership to achieve common aims and objectives. However, if there are occasions where the PCT and practices cannot agree on an issue, then an arbitration process will be implemented. If it is felt that the PCT is unable to resolve local differences then the Strategic Health Authority will be called upon to arbitrate.


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We agree to be bound by the terms of the Commissioning Framework Agreement

Signed on behalf of the PCT: Signature

Michael Potts Chief Executive Kirklees PCT

Signed on behalf of the Consortium: Signature

Print Name


http://www.kirklees.nhs.uk/fileadmin/documents/publications/JG_Practice_Based_Commissioning_Agreemen  

http://www.kirklees.nhs.uk/fileadmin/documents/publications/JG_Practice_Based_Commissioning_Agreement_consortium_version_2008.pdf

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