Appendix 2: Public Health Contracts transferring to the London Borough of Barnet from 1 st April 2013 and contracting approach.
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1 Appendix 2: Public Health Contracts transferring to the London Borough of Barnet from 1 st April 2013 and contracting approach. 1. Contract Values The table below shows the total value of contracts to be transferred to the London Borough of Barnet valued at 8.78m based on 2013/14 contract values. Contract Provider Value Treatment s for Drugs and Alcohol Misuse Barnet Drug & Alcohol Service Barnet, Enfield and Haringey Mental Health Trust 1,332,316 Westminster Drug Project Westminster Drug Project 1,082,000 Inpatient Detox Equinox Nth 137,000 Haringey Advisory Group for Alcohol Haringey Advisory Group for Alcohol 164,000 Case Management System Illy 20,000 Subtotal 2,735,316 Sexual Health Claire Simpson Clinic GU Barnet and Chase Farm Hospitals 1,009,000 Marlborough Clinic GU Royal Free Hospitals 662,000 Mortimer Market and Central and North West London 643,000 Archway GU s Foundation Trust GU Barnet, Enfield and Haringey MH Trust 166,000 GU Whitington Hospital 32,516 GU Various providers 837,500 Contraception and sexual Central London Community Health 910,153 Contraception and sexual Barnet, Enfield and Haringey MH Trust 15,000 Sexual and reproductive Barnet GPs 17,000 health LES Chlamydia screening Barnet and Chase Farm Hospitals 6,000 Hepatology Central and North West London Foundation Trust 6,000 Subtotal 4,304,169 Central London Community Health 333, Royal Free Hampsted 39, Smoking LES Barnet GPs 174, Licence for Quit Manager system - web based data system North 51 10, NRT spend in pharmacies NRT spend in pharmacies 15, Subtotal 573, School Nurses School Nursing Service Central London Community Health 1,147, School Nursing Service Barnet, Enfield and Haringey MH Trust 21,000.00
2 Subtotal 1,168, Total 8,781, Proposed Way Forward for Public Health Contracts 2.1 Section 1: Genito-Urinary contracts (Sexual Health Contracts) Due to the clinical nature of the s and the number of providers accessed by Barnet and Harrow residents, it has been agreed to keep GU s within the Standard NHS contracts with the relevant acute providers and for the local authorities to be named as associate commissioners to the contracts. This means that contracts will be negotiated by the relevant Commissioning Support Units (CSUs). This position is shared by the NWL boroughs and it is assumed at this point that NCL boroughs will also agree to this. We are recommending seeking cap and collar contracts with providers for GU in 13/14 to ensure that financial risk is managed and limited to the resources available. This means that there will be a maximum rate (cap) and a minimum rate (collar) applied. This will provide Barnet with the certainty of not paying more than the maximum rate. In addition, we are seeking better data reporting as many providers are not reporting activity on the GUM monthly access system and under current guidance and NHS commissioning rules, providers are not required to provide patient level data to commissioners due to the additional level of patient confidentiality attached to sexual health. 2.2 Central London Community Health (CLCH) This provider currently provides school nursing, family planning and smoking cessation s for Barnet. These s form part of an overall block contract worth approx. 41m with the s due to novate worth approx. 2.4m per annum. The provider and NCL are currently undertaking a contract rebasing exercise as it was recognised that the values apportioned within the block are inaccurate. It has been agreed that the rebasing will be done without any change to the bottom line value of the contract. To date, the s due to novate to the LA have seen significant changes in the values with the current position showing an increase cost of 170k overall against these three s. North Central London CSU will negotiate the contract with input from the Public Health team and the recommended option is to move the family planning and smoking cessation s onto the existing Barnet Council contract with CLCH. Separate consideration of the school nursing is covered in the section of this paper relating to Ealing Hospital Trust.
3 2.3 Barnet, Enfield and Haringey Mental Health Trust This provider currently provides drug and alcohol for Barnet. They also provide some family planning s under open access via their family planning s in Enfield and a cross border school nursing. It is proposed that the NCL CSU will negotiate the contract with input from the Public Health team. Letters setting out proposed levels of efficiencies to be achieved etc. have already been exchanged. The contracting options available are: To keep the s within the standard NHS Contract with Barnet Council listed as an associate commissioner. To move the s onto a contract with Barnet council. This could involve negotiating a new contract with BEHMHT for these s. Work is being undertaken to determine the most appropriate contracting mechanism. 2.4 School Nursing Ealing Hospitals Trust (Integrated Care Organisation) (ICO) currently provides the school nursing for Harrow and the issues for school nursing are shared across both Boroughs and apply to the situation for school nursing in Barnet with CLCH. The understanding to date is that both boroughs were going to have a contract with the relevant providers for school nurses rather than being associates to the current NHS contracts. As well as the Child Measurement Programme, school nursing are responsible for delivering the Healthy Child Programme for 5-19 year olds and providing the main health input to child protection cases. This work for 0-5 year olds is delivered by the Health Visiting which will be commissioned by the NHSCB in 13/14 and 14/15 with responsibility moving to the Councils in April Some London boroughs have already decided to leave the School Nursing s in NHS contracts for 13/14 and be associate commissioners to those contracts. It is likely that the NHS Commissioning Board (NHSCB) will ask Clinical Commissioning Groups (CCGs) to keep Health Visiting within existing NHS contracts and be an associate commissioner to those rather than entering into separate contracts. The Public Health commissioners are currently working towards understanding the plans the NHSCB have for commissioning Health Visiting in Harrow and to understand better the reasons behind the decision in other areas for the borough to be associate commissioners to NHS contracts for School Nursing.
4 Work is still in progress to agree an approach to commissioning school nursing for Harrow. The Council is keen to ensure that all future contracts however are under the terms and conditions of the Council and the contract clearly links to the expected deliverables. 2.5 All other contracts For the most part, contracts held with non NHS providers are for single lines and are generally straightforward transfers to the Council. The steps taken for these contracts have included: Reviewing council contract terms to ascertain if any additional schedules are needed Drafting new contracts for each provider and reviewing specifications and contract schedules Agreeing costs, data requirements, KPIs and quality standards for 2013/14 Aggregating contracts with existing provider contracts where appropriate Locally Enhanced Contracts are shared between GP Consortiums and local pharmacies and are currently valued at 473,000. Harrow is seeking to develop a framework with a call off period for the LES contracts and officers are liaising with the current providers. Further guidance from Department of Health is anticipated to provide further clarity on these specific contracts. The summary position for all Barnet contracts is shown in the table below Contract Commissioner Value Treatment s for Drugs and Alcohol Misuse Barnet Drug & Alcohol Service 1,332,316 LBB will be the lead commissioner and Westminster Drug Project 1,082,000 where possible will combine with Inpatient Detox 137,000 existing LBB contracts with the Haringey Advisory Group relevant providers for Alcohol 164,000 Case Management System 20,000 Subtotal 2,735,316 Sexual Health Claire Simpson Clinic GU LBB will be the associate commissioner; the NHS will be the lead commissioner and will directly manage the contract with these providers in conjunction with LBB. This is advantageous for LBB due to the number of providers for this openaccess. We will seek to negotiate a cap on the 1,009,000 Marlborough Clinic GU 662,000 Mortimer Market and 643,000 Archway GU s GU 166,000 GU 32,516 GU cost of Genital Urinary Medicine. 837,500 Contraception and sexual 910,153 LBB will be the lead commissioner and we will seek to integrate this into the existing contract between LBB with Central London Community Health
5 Care LBB will be the lead commissioner 15,000 Contraception and sexual Sexual and reproductive 17,000 health LES Chlamydia screening 6,000 Hepatology 6,000 Subtotal 4,304,169 Smoking LES Licence for Quit Manager system - web based data system LBB will be the lead commissioner and 333, we will seek to integrate this into the existing CLCH contract with LBB LBB will be the lead commissioner 39, The plan is for LBB to be the lead 174, commissioner; however with Local Enhanced there are issues to be resolved regarding clinical governance and GP relations. LBB will be the lead commissioner 10, NRT spend in pharmacies 15, Subtotal 573, School Nurses School Nursing Service LBB will be an associate 1,147, School Nursing Service commissioner for reasons of clinical governance and children pathways, the NHS will remain the lead commissioner 21, Subtotal 1,168, Total 8,781,056
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