Contracting with the NHS and healthcare organisations

• Identify where financial responsibility rests — whilst healthcare is generally a free-for-all, certain social services are means-tested. Sometimes individuals are able, or are required, to pay towards their social care to receive additional or better services. Sometimes the local authority is also under a duty to contribute towards those costs. You should ensure that your contracts document your relationship with each party that is responsible for their element of the funding and that your rights and responsibilities in each contract are aligned.

• Can you negotiate around NHS standard terms? — the NHS’ Standard Terms Contract is used by all commissioners for healthcare services (other than primary care). It is updated annually and contains three parts: the particulars, the standard terms and conditions and the service conditions. Whilst the latter two are generally fixed, the particulars are negotiable and it is worth reviewing these in detail to reach an agreement with your commissioner on price, contract term, options to extend and service specification.

• Does the contractual party have capacity? — often people who are able to pay for their own social care may lack the capacity to enter into contracts for those services. You should ensure that you are familiar with the provisions of the Mental Capacity Act 2005, the rights and responsibilities of deputies, the rights and responsibilities relating to Powers of Attorney and have appropriate Deprivation of Liberty procedures in place. A person’s ‘next of kin’ cannot sign a contract on their behalf (and importantly will not be bound by its terms) unless they have the correct legal authority to do so.

• Ensure quality of service, not just financial due diligence — health and social care providers are subject to regulation by NHS Improvement, the Care Quality Commission and numerous professional councils. Poor ratings can be an absolute block to entering into tenders and may have significant reputational implications. Service providers need to demonstrate good quality services and ‘value for money’ rather than just offer the lowest price.

• How do you bid for a contract? — health and social care services are subject to the ‘Light Touch Regime’ in procurement. This potentially opens up opportunities for bidders to discuss the award criteria, seek specialist advice and be more creative in the design of services that demonstrate ‘added value’.

• Are your services innovative? — other ‘movers and shakers’ include NHS Vanguards that work with organisations outside of the NHS to redesign the health and social care system, in order to address the needs of local communities. They can provide more ground-breaking and flexible routes to providing health and social care services that a traditional Clinical Commissioning Group (CCG) may not have the infrastructure or resources to implement.

• What is the local health board’s stance? — health and wellbeing boards bring together various public sector bodies to plan how to meet the health needs of their local population. Being familiar with your local board’s plan will provide you with insights into their strategies to integrate the local area services, and can deepen your understanding of the commissioning strategies that will shape the health market.

If you would like more information about the topics discussed, please contact Emma Watt.

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