What is the NHS System Oversight Framework and what does it mean for procurement going forward?

NHS

At the end of June, NHS England (NHSE) announced plans to transform the way integrated care systems (ICSs) buy non NHS goods and services in a document entitled NHS System Oversight Framework 2021/22.

But what is the significance of this framework? And what will it change for companies and organisations looking to land NHS contracts?

What is the NHS System Oversight Framework?

The NHS System Oversight Framework for 2021/22 replaces the NHS Oversight Framework for 2019/20, which brought together arrangements for provider and Clinical Commissioning Groups (CCGs) oversight in a single document.

The purpose of the document/framework is to reinforce the system-led delivery of integrated care, in line with the vision set out in the NHS Long Term Plan, the White Paper Integration and Innovation: Working Together to Improve Health and Social Care for All, and aligns with the priorities set out in the 2021/22 Operational Planning Guidance.

This framework applies to all Integrated Care Systems (ICSs), Clinical Commissioning Groups (CCGs), NHS trusts and foundation trusts and focuses on five key metrics:

  1. Quality of care
  2. Access and outcomes
  3. Preventing ill health and reducing inequalities
  4. People; finance and use of resources
  5. Leadership and capability

The approach to oversight is characterised by the following key principles:

a. working with and through ICSs, wherever possible, to tackle problems

b. a greater emphasis on system performance and quality of care outcomes, alongside the contributions of individual healthcare providers and commissioners to system goals

c. matching accountability for results with improvement support, as appropriate

d. greater autonomy for ICSs and NHS organisations with evidence of collective working and a track record of successful delivery of NHS priorities, including tackling inequality, health outcomes and access

e. compassionate leadership behaviours that underpin all oversight interactions

Implementation of the framework

While the scope of this framework reflects the role of NHS England and NHS Improvement as a national regulator of NHS provided and/or commissioned  services, it also recognises that ‘the vision for ICSs is based on the core principles of equal partnership across health and local government: subsidiarity, collaboration and flexibility’ and that ‘delivering the priorities for the NHS depends on collaboration across health and care, both within a place and at scale’.

But implementing the framework won’t be easy and straight forward.

NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.

But implementing the framework won’t be easy and straight forward.

NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.

When will the framework be implemented?

The existing statutory roles and responsibilities of NHS England and NHS Improvement in relation to trusts and commissioners remain unchanged for 2021/22. The framework sets out how NHS leaders and organisations will be required to operate with their partners in ICSs from April 2022.

The oversight framework will be updated further for 2022/23. The updated document is expected to confirm ICSs’ formal role in oversight including:

bringing system partners together to identify risks, issues and support needs and facilitate collective action to tackle performance challenges

and

leading oversight and support of individual organisations and partnership arrangements within their systems.

What does it all mean going forward?

The thinking behind the framework is that local NHS procurement teams will be able to change the way they buy non-NHS goods and services and move towards a more system-level way of working, and away from procurement teams dedicated to single organisations.

ICSs will be able to “tailor their procurement organisation structure based on their respective level of maturity, spend profiles, associated phasing of roles and local considerations” but the lack of data harmonisation at local, regional and national level and clarity around best practice approach could make implementation difficult.

With regards to companies who are looking to supply the NHS at a local level, they will have to keep an eye on how this framework develops between now and April 2022 and establish relationships with the ICSs who will soon be in charge of their own procurement and spending.

If you are looking for help with securing NHS contracts, contact the K Low Consulting team on 0330 1331 041 or info@klowconsulting.com.

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