Private companies will be able to bid for contracts to run every aspect of the care of patients with long-term conditions at a series of pilot sites, under a radical new Government scheme.
Ministers are to put out to tender contracts for six ‘year of care’ schemes intended to incentive major providers to keep people out of hospital by making them responsible for the entire patient pathway, under a single budget tariff.
A supporting document for applications from aspiring providers of the schemes provides a list of four potential funding models, including one under which a principal contract holder would then sub-contract aspects of care to other providers.
This model could ‘attract new providers which are able to offer cost-effective, high-quality care’, and allow providers to focus on prevention and primary care ahead of expensive emergency treatment, the Department of Health said.
But it admitted there were potential risks to the model too, including potential challenge to implementation from local politicians and possible issues around competition.
Private providers of care pathways will not bear the financial risk if there is an overspend, and any savings on the planned budget will be ploughed back into the local NHS rather than being kept as a profit share by companies.
Dr Oliver Bernath, managing director of Integrated Health Partners, said his company would be bidding to run care at one of the pilot sites, adding the ‘year of care model’ was one IHP had been ‘pushing for a number of years’.
He said: ‘Current financial arrangements are not conducive to working on the efficiency of a total year of care for patients with long-term conditions. There are no payment mechanisms that encourage providers to avoid complications. If the holder of this year of care tariff also has to pay for emergency treatment, they will be incentivised to make sure the patient stays well.’
But Dr Louise Irvine, a GP in Lewisham, said she was ‘concerned’ about the initiative.
‘There is a lot of cause for concern when we see private companies running services for vulnerable people. We can see how they can cut costs and standards.’
The deadline for applications is 25 May and the DH said it would give each pilot site financial support of £95,000 from April 2012 to March 2013. This would ‘support clinical, performance, finance and analyst involvement’.