A tariff (price) for specific healthcare activity is paid by the PCT to healthcare providers. This is determined nationally. Payment by results complements practice based commissioning as it enables a unit cost calculation to develop the indicative practice level budgets for practice based commissioning. For mental health, payment by results is not operational. A national target date for the introduction of payment by results for mental health is 2008. Foundation Trusts By 2008, all provider NHS Trusts to become Foundation Trusts. This affects the commissioning / provider relationship for the following reasons:- Foundation Trusts are able to borrow money and invest money without some of the current restrictions. Foundations Trusts require that the service level agreement with commissioner is a legally binding contract for a three year period. This differs from the current arrangement of a one year service level agreement which has no legal status. Foundation Trusts have greater flexibility to commission the voluntary and private sector directly to provide services on their behalf. The Local Authority through integrated services will need to have a robust governance structure in place with the Trust for service provision and with health commissioners to manage demand and cost. Provide for greater accountability at a local level through revised governance arrangements. Individualised Budgets Changes in the way in social care packages are costed and managed through providing an individualised budget from which services are commissioned. Power shifts from the Council to the individual to manage the social care market with the support of effective information, advice and brokerage systems. Individualised budgets can include streams of funding including supporting people, independent living fund, access to work in addition to social care budgets. Health Act Flexibilities (referred to as Section 75 partnership agreements)
A tariff (price) for specific healthcare activity is paid by the PCT to healthcare providers. This is determined nationally. Payment by results complements practice based commissioning as it enables a unit cost calculation to develop the indicative practice level budgets for practice based commissioning. For mental health, payment by results is not operational. A national target date for the introduction of payment by results for mental health is 2008. Foundation Trusts By 2008, all provider NHS Trusts to become Foundation Trusts. This affects the commissioning / provider relationship for the following reasons:- Foundation Trusts are able to borrow money and invest money without some of the current restrictions. Foundations Trusts require that the service level agreement with commissioner is a legally binding contract for a three year period. This differs from the current arrangement of a one year service level agreement which has no legal status. Foundation Trusts have greater flexibility to commission the voluntary and private sector directly to provide services on their behalf. The Local Authority through integrated services will need to have a robust governance structure in place with the Trust for service provision and with health commissioners to manage demand and cost. Provide for greater accountability at a local level through revised governance arrangements. Individualised Budgets Changes in the way in social care packages are costed and managed through providing an individualised budget from which services are commissioned. Power shifts from the Council to the individual to manage the social care market with the support of effective information, advice and brokerage systems. Individualised budgets can include streams of funding including supporting people, independent living fund, access to work in addition to social care budgets. Health Act Flexibilities (referred to as Section 75 partnership agreements)
20161017_mh_strategy_15-20_final.docx