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Purpose of Report 1.1

To provide the Board on current status of the commissioning provider split.


To put in place a recommendation for the next 12 months

Background 2.1

One of the key guidelines following the Commissioning a Patient Led NHS document was that PCT’s had to split their provision and commissioning arrangements. A further recommendation was that PCT’s should consider exploring alternative models for the provider arm. This meant exploring options such as community foundation trusts or social enterprises.


From a provision perspective the key issue has to be the services provided to patients and in the context of community services, out of hospital care. The Provider Board has already agreed that ensuring the continuation of high quality, responsive and cost effective care is the overriding factor in considering the future of provider services.

Existing governance arrangements 3.1

The creation of the provider board was previously approved by the Board. Provider board is chaired by Vanessa Stirrum, and Rob Millington sits on it as a non executive director. Further representation is made from the corporate affairs, patient care and professions, finance, and HR departments. The board has now met 6 times, and is currently setting up the clinical governance sub committee structure which will report to it. This arrangement sees the provider arm operating at arms length. This structure does comply with the guidance NHS Yorkshire and the Humber are putting in place.


The national and regional picture 4.1

The Department of Health are currently giving no specific guidance on the future direction of PCT provider services. The movement towards any type of social enterprise has been slowed – this has been demonstrated with a fellow PCT in Yorkshire and the Humber actively stepping back from becoming a social enterprise. The work on community foundation status is continuing within a few provider services arms, however there is still a lot more detail to be put in place on this particular issue.



There is a strong provider services network in place across Yorkshire and the Humber. This is both at Director and Assistant Director level. This network is working together to move this agenda forward.


At present all provider arms within PCT’s are operating at arms length within their PCT’s.

Next Steps 5.1

Work should continue to build capacity and capability within the PCTs provider arm to ensure that it can function as a stand alone organisation. This will position it well to respond to any future changes. The Service Level Agreement PCT and the provider arm and associated performance management arrangements should be developed and strengthened. Engagement in the wider SHA network of provider services organisations should continue as a means of sharing good practice and keeping abreast of developments across Yorkshire and the Humber.


Recommendations 6.1

The Board Agrees: That the PCT provider arm remain at Arms length for at least 12 months (up until December 09), unless the national or regional picture alters significantly. That work should progress as detailed in section 5 above.