Attain was commissioned by an ICB to develop a contracting strategy that responds to the ambition of the Health and Care Act to create integrated care systems.

  • The objectives were to develop a vision for contract management that all system partners agree upon, and create a culture consistent with collaborative working in an integrated care system.
  • The implementation of the strategy required a new contracting operating model with a down-sized function in the ICB, and knowledge transfer to system partners with delegated responsibilities.

What We did

  • We focused on the practical implementation of the Health and Care Act to form the basis of the strategy. We asked what is the ambition of the Act and what does this mean for relationships, system and provider objectives, and contracts?

  • We categorised providers and contracts to set the desired relationship and new ways of working using a tiered approach, recognising strategic providers where outcomes should be jointly set and relationships developed, similar to best practice In the private sector.

  • We engaged with stakeholders to refine the approach and create a 5-year plan with a phased delegation to strategic providers/collaboratives, creating a truly integrated NHS system.

Outcomes

  • Through alignment with the Health and Care Act and emerging NHSE guidance on delegation, stakeholders were aligned to the long-term contracting strategy and desired outcomes.

  • The immediate priorities and contracts tiering provided a short/medium-term operating model while system contracting capability is increased prior to full delegation to system partners.

  • The internal delegation of contracts to end-users allowed scarce contracting expertise to be focused on where it has greatest impact (i.e. strategic providers).

  • The contracting strategy output broadly sets out the plan for increasing system integration for all partners/organisations.