Health Services: CCG Contracts — Friend or Enema! Part 3

Thanks to Stephen Ashcroft of Brian Farrington for his series around this month’s hot topic, Health Services. Parts 1 and 2 were published here and here. Today we bring you the final part -- General Conditions. 

General Conditions

The 2014/15 NHS Standard Contract reflects the requirements set out in ‘Everyone Counts: Planning for Patients 2014/15 to 2018/19. The contract comprises three parts:

1.The Particulars

2.Service Conditions (SC)

3.General Conditions (GC)

This part of the contract has 80 pages. Readers should note that if there is any conflict or inconsistency between the provisions of the Contract, the General Conditions are first in the order of priority.

Providers are required at GC 4 ‘Transition Period’ to “…work together and use all reasonable endeavours to assist each other to facilitate the delivery of the services…” There is a requirement for the Co-ordinating Commissioner to deliver the Commissioner Documents to the Provider. There have been legal arguments in other contracts about the term ‘reasonable endeavours.’ It is not as demanding as ‘best endeavours’ which fundamentally would require the Provider to commit almost unlimited resources to solve an issue.

At GC 5.2 there are potentially serious consequences for a Provider especially if they are sub-contracting services. In Definitions (page 73) and Staff is defined as all persons employed or engaged by the Provider or any Sub-Contractor. The clause 5.2.1 provides “The Provider must ensure that there are sufficient appropriately registered, qualified and experienced medical, nursing and other clinical and non-clinical Staff to enable the Services to be provided in all respects and at all times in accordance with this Contract.” If a sub-contractor does not comply with all these requirements, it is the Provider who is contractually accountable to the CCG. The Provider therefore requires an excellent process to audit the sub-contractor’s compliance. Note the word ‘sufficient’ – who decides what sufficient means? Note the words ‘qualified’ and ‘experienced’ – who decides what these words mean? They are not defined in the contract.

At GC 8 ‘Review’ it provides for Review Meetings to be held at intervals set out in the Particulars. The contract provision uses the word ‘must’ and that leaves no doubt that it is an obligation on the Co-ordinating Commissioner and the Provider. In the past there is no doubt that, in some instances, no review meetings have been held by Trusts. It requires a resource and also knowledge and skills to conduct an effective review meeting. The ‘Review’ required at GC 8 is very much in the interest of a Provider. Among the provisions are to review and discuss:

8.1.2      Performance of the Parties under this Contract;

8.1.4      levels of Activity, Referrals and Utilisation under this Contract;

8.1.6      the Prices; and

8.1.7      any other matters that either considers necessary in relation to this Contract.

Is this clause worthy of careful thought for those accountable in CCGs?

CCG Contracts: Friend or Enema! Conclusion

Occasionally the parties to a contract will have a dispute. One way to reduce the potential for this occurring is for both parties to have a clear understanding of the detail of the contract. It can be postulated the CCGs are more likely to have expert legal and procurement advice readily to hand than are many Providers. Whatever the case -- it is advised, if in any doubt, to seek advice on any facet of a contract of which they are unsure of the consequences.

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