Hot Topics: Accountable Care Organisations Produced by NHS Librarians for , May 2017 What is an Accountable Care Organisation? An Accountable Care Organisation (ACO) or Accountable Care System (ACS) brings together a number of providers (e.g. acute hospital care, general practice, mental health, social care, ambulance services and pharmacies) to take responsibility for the cost and quality of care for a defined population within an agreed budget (1). ACOs have been proposed as one way of overcoming fragmented responsibility for the commissioning and provision of care in the NHS. They could in principle offer an organisational structure that draws together previously siloed or competing providers into a network with a shared sense of purpose and financial interest (3). Next Steps on the Five Year Forward View (5) describes ACOs as “an evolved version of an STP” and states that ACOs “provide joined up, better coordinated care”. It published the names of nine geographical areas that are likely to emerge as ACOs in 2017/18. What can we learn about ACOs from elsewhere? ACOs have evolved recently in the United States and they build on a much longer history of integrated care systems such as and (1). In the UK, three ‘Vanguard’ schemes stated their intention to explore the potential of the ACO as an organising structure in the NHS: , and (3). The first wave of Integrated Care Systems (formerly shadow Accountable Care Organisations) are currently assuming accountability for local operational and financial performance in: South Yorkshire and Bassetlaw, Frimley Health and Care, Dorset, Bedfordshire, Luton and Milton Keynes, Nottinghamshire, Blackpool and Fylde Coast, West Berkshire, Buckinghamshire, Greater Manchester (devolution deal), Surrey Heartlands (devolution deal) (8). What are the challenges involved? Relationships: Establishing strong relationships between the leaders of participating organisations and the clinicians who deliver care; Technology: Accelerating the implementation of electronic care records to help predict avoidable hospital admissions and to coordinate discharge planning; Finance: New ways of commissioning and paying for services need to be established across traditional organisational boundaries (1). Legal challenge: The proposed changes to regulations and consultation on the draft ACO contract have resulted in two legal challenges from 999 Call for the NHS and JR4NHS. (7) Further reading
Hot Topics: Accountable Care Organisations Produced by NHS Librarians for , May 2017 What is an Accountable Care Organisation? An Accountable Care Organisation (ACO) or Accountable Care System (ACS) brings together a number of providers (e.g. acute hospital care, general practice, mental health, social care, ambulance services and pharmacies) to take responsibility for the cost and quality of care for a defined population within an agreed budget (1). ACOs have been proposed as one way of overcoming fragmented responsibility for the commissioning and provision of care in the NHS. They could in principle offer an organisational structure that draws together previously siloed or competing providers into a network with a shared sense of purpose and financial interest (3). Next Steps on the Five Year Forward View (5) describes ACOs as “an evolved version of an STP” and states that ACOs “provide joined up, better coordinated care”. It published the names of nine geographical areas that are likely to emerge as ACOs in 2017/18. What can we learn about ACOs from elsewhere? ACOs have evolved recently in the United States and they build on a much longer history of integrated care systems such as and (1). In the UK, three ‘Vanguard’ schemes stated their intention to explore the potential of the ACO as an organising structure in the NHS: , and (3). The first wave of Integrated Care Systems (formerly shadow Accountable Care Organisations) are currently assuming accountability for local operational and financial performance in: South Yorkshire and Bassetlaw, Frimley Health and Care, Dorset, Bedfordshire, Luton and Milton Keynes, Nottinghamshire, Blackpool and Fylde Coast, West Berkshire, Buckinghamshire, Greater Manchester (devolution deal), Surrey Heartlands (devolution deal) (8). What are the challenges involved? Relationships: Establishing strong relationships between the leaders of participating organisations and the clinicians who deliver care; Technology: Accelerating the implementation of electronic care records to help predict avoidable hospital admissions and to coordinate discharge planning; Finance: New ways of commissioning and paying for services need to be established across traditional organisational boundaries (1). Legal challenge: The proposed changes to regulations and consultation on the draft ACO contract have resulted in two legal challenges from 999 Call for the NHS and JR4NHS. (7) Further reading