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28.07.16

MCP Vanguard model to reach a quarter of country next year with fresh funding

A new national New Care Models funding stream will contribute to support additional multi-speciality care partnerships (MCPs) nationwide, NHS England has said, just as its chair, Sir Malcolm Grant, highlighted the importance of getting the MCP contract right in order to implement STPs and spur further integration.

In an MCP contract framework published ahead of its board meeting today, NHS England’s national director for commissioning strategy, Ian Dodge, set the stage for the imminent draft of the MCP contract, which will be published at the end of September.

Although the MCP model has only been made available to the 14 test sites so far as part of the Vanguard programme – all of which now serve a minimum population of 100,000 – it will soon be made available to other providers through a New Care Models funding stream.

“In 2017-18 we expect to expand national support from coverage of about 8% of the country now, to around a quarter. This autumn NHS England and NHS Improvement will be inviting applications for national support for future MCPs, PACS (Primary and Acute Care Systems) and acute care collaborations, linked to the next phase of sustainability and transformation planning,” Dodge wrote.

“The most compelling plans for the next MCPs are likely to cover specific communities in 17-18, with wider spread thereafter, rather than all of the CCG or whole STP footprint at the same time.

“Once we have selected geographies, NHS England’s Investment Committee will continue to make investment decisions based on individual plans to deliver value – in particular, a return on investment through a combination of demand moderation and provider efficiency, that are consistent with agreed STP financial assumptions.”

Today’s MCP framework, which invites feedback until 2 September, described the model as more than just the recreation of a PCT, a new form of practice-based commissioning, or GP multi-fund.

“An MCP combines the delivery of primary care and community-based health and care services – not just planning and budgets,” Dodge said in the report. “It also incorporates a much wider range of services and specialists wherever that is the best thing to do.

“The fully integrated MCP has a single whole population budget across the range of services it providers. It creates a new care model, backed by a new business model, based on the GP registered list. No accountable care provider is viable without the full support and engagement of general practice.”

He added that the model, which started being tested by the 14 MCP vanguard sites ahead of any formal national policy, is a “critical enabler” of the GP Forward View.

“When general practice fails, the NHS fails. A big reason to develop an MCP is to provide practical help to sustain general practice right now. It supports practices to work at scale and also to benefit from working with larger community based teams,” Dodge said.

During NHS England’s board meeting, Dodge added that the MCP framework will finally allow primary care providers to join up services – although he did recognise that, despite good progress, more must be done in terms of MCPs’ impact on inequalities and social care.

The MCP is, along with the PACS, an innovative place-based model of care, serving the whole population rather than its important subsets – something long advocated by key healthcare leaders.

It success depends on how it grows and deploys its assets, including by building social networks, community resilience and patient activation; harnessing technology; and empowering staff to work in multidisciplinary teams.

Ongoing work and support

Currently, the New Care Models team at NHS England – led by Louise Watson, who runs the MCP element of the programme – is supporting the 14 MCP vanguards in their journey towards moving from ‘aspirant MCPs’ to achieving full maturity over the next few years.

“This includes implementing all the core components of the framework; and achieving an agreed and clear return on investment through a combination of demand moderation and provider efficiencies,” the report said.

Other support includes ongoing evaluation of impact against national and local metrics; developing a “suite of impact studies”; applying rapid cycle learning/improvement techniques; and delivering technical and hands-on support including with technology, workforce and system leadership.

Ed Weller is also leading on a dedicated MCP contract development team, looking at “complex and interrelated” policy and implementation questions on new commissioning, contracting, organisational forms and funding methodologies.

Weller’s team is working “intensively” with six sites in particular, including Dudley, West Birmingham and Sandwell, Southern Hampshire, Whistable and Canterbury, Wakefield, and the Greater Manchester devolution area.

 

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