NHS England has confirmed the launch of a consultation on the contracting arrangements for Accountable Care Organisations (ACOs).
There is widespread support for ending the fragmented way that care has been provided to improve services for patients and the NHS has been working towards this in a number of ways.
ACOs are just one of these ways and are intended to allow health and care organisations to formally contract to provide services for a local population in a coordinated way.
An ACO is not a new type of legal entity and so would not affect the commissioning structure of the NHS. An ACO would simply be the provider organisation which is awarded a single contract by commissioners for all the services which are within scope for the local accountable care model. Therefore any proposal to award an ACO contract would engage local commissioners’ own duties under the NHS Act 2006. Any area seeking to use an ACO contract would need to comply with longstanding public procurement law.
The consultation will set out how the contract fits within the NHS as a whole, address how the existing statutory duties of NHS commissioners and providers would be performed under it (including how this would work with existing governance arrangements), and will set out how public accountability and patient choice would be preserved.
Subject to the outcome of the consultation, the two areas at the forefront of using a contract of this sort are Dudley, and Manchester’s proposed local care organisation. Emerging bidders for both proposals are NHS bodies, have the support of local GPs and are not private sector organisations.
Given the interest in the ACO proposals NHS England will hold a 12-week public consultation process to provide further clarity about their role and scope.
NHS England will seek views from stakeholders and the public as well as explaining what the contract is, why it is useful and what it would mean for patients and for the NHS. No ACO contract will be awarded in the meantime.
ACOs are only one tool for integrating primary care, mental health, social care and hospital services and not the only or main way to integrate services. Most areas are seeking to do so through voluntary, non-contractual partnerships where GPs, hospitals, commissioners and local government collaborate to improve services for their population. NHS England will be announcing the next wave of these collaborative partnerships shortly.
