NHS reforms

Coventry and Warwickshire STP aiming for ACS status this autumn

Coventry and Warwickshire sustainability and transformation partnership (STP) could become the first in the West Midlands Combined Authority (WMCA) area to enter the new Accountable Care System (ACS) structure.

In a WMCA wellbeing board report, it was noted that the STP could enter the structure “as early as autumn this year” and offers “great opportunities for learning for the other STPs”.

NHS England’s Five Year Forward View update recently revealed that ACSs would now be considered an ‘evolved’ version of an STP that is working as a locally integrated health system. It was also noted that, in time, some ACSs may lead to the establishment of an accountable care organisation (ACO). This is where the commissioners in that area have a contract with a single organisation for the great majority of health and care services and for population health in the area.

The WMCA report, which had a section focused on moving from ACSs to ACOs, noted that “where there is a strong set of partnerships locally, along with mature decision making and a defined shared improvement infrastructure and evidence of a clear plan, these areas are invited to consider moving forward toward accepting greater place-based accountability and system leadership”.

It went on to state that nine geographies nationally have already put forward their submissions to move toward this greater autonomy.

“In the West Midlands, each STP is invited to have the discussion on their ambition and identify if they are ready now- to move to this in this year, or are confident they will be ready early in 2018-19, or are not ready yet,” it read. “Coventry and Warwickshire have indicated that this STP is likely to be the first in our WMCA area to go into this new ACS structure.”

The document also goes into detail about what the implications of the move could be on future commissioning in the NHS. It stated that commissioning in CCGs and NHS England would likely adopt a greater strategic role within and across STPs.

“This will require CCGs to develop structures across the STP footprint to enable a ‘single view’ on key decisions; this can be through a joint committee structure or in some instances a merger of CCGs,” the report continued.

It also explained how the three CCGs in the Coventry and Warwickshire STP are looking to establish a joint committee and a shared management team between two CCGs within the region.

“As these ‘strategic commissioners’ develop, this may mean that STP commissioners taking on some of the functions from NHS England on planning and assurance and some STPs delegating some of their functions to service providers to manage pathways,” it concluded.

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