All health and social care organisations that drew up plans to overhaul care in England will eventually become accountable care systems, according to new plans released by NHS England.
Regional organisations that created sustainability and transformation plans (STPs) will ‘evolve’ into accountable care systems (ACSs), with some acquiring the status as early as April this year.
NHS England’s Five Year Forward View delivery plan has said that hospital trusts, CCGs and local authorities in the new ACSs will ‘take on clear collective responsibility for resources and population health’.
However, the report notes that CCGs alone will be responsible for improving emergency admission rates, which will be measured and managed on an STP or ACS level from April.
To do this, NHS England has committed to working with ‘upper quartile higher referring GP practices and CCGs’ to standardise the ‘clinical appropriateness’ of hospital referrals, using CCG data and ‘a new tool from NHS Digital’.
Simon Stevens, head of NHS England, announced at a Parliamentary Accounts Committee meeting last month that between six and ten STP areas would be launching as so-called accountable care organisations (ACOs).
However, the delivery plan says that ACOs are the next step after becoming an ACS, with some becoming an accountable care organisation ‘in time’.
In return for becoming an ACS, NHS England has promised the organisations ‘more control and freedom’ over their regional health system including receiving devolved national GP Forward View, mental health and cancer funding from 2018.
The healthcare systems will be set up in stages with the first to be implemented from April this year.
NHS England noted nine STP areas that are ‘likely candidates’ to become the first ACSs, including:
- Frimley Health
- Greater Manchester
- South Yorkshire & Bassetlaw
- Nottinghamshire, with an early focus on Greater Nottingham and the southern part of the STP
- Blackpool & Fylde Coast, with the potential to spread to other parts of the Lancashire and South Cumbria STP at a later stage.
- Luton, with Milton Keynes and Bedfordshire
- West Berkshire
The delivery plan added that areas applying for ACS status should have ‘successful vanguards, ‘devolution’ areas, and STPs that have been working towards the ACS goal’.
Chris Hopson, chief executive of NHS Providers, said NHS England’s new plans recognise that the Health and Social Care Act 2012 ‘prevents the creation of a formal ‘mid level STP tier’ with statutory powers’.
He said: ‘The plan also recognises the importance of existing governance and accountability structures focused on trusts, but also the opportunity for shared decision making at the STP level.
‘Finally, it allows different STPs to move at different speeds: enabling the fastest to progress without delay but not forcing others to adopt a single uniform approach they neither want nor are ready for.’