NHS England has published the 2020/21 versions of the Full-Length and Shorter-Form NHS Standard Contract. The 2020/21 versions will replace the 2019/20 versions and are available here.
The three-part structure of the NHS Standard Contract remains unchanged, with the contract comprising the Particulars, the Service Conditions and the General Conditions. As before, the Shorter-Form version takes a more “light-touch” approach than the Full-Length version, which contains more detailed terms.
The changes have been made following a consultation process carried out by NHS England which invited stakeholders to comment on the proposed changes. Draft versions for the purposes of the consultation were published in December 2019 and the consultation closed on 31 December 2020.
The key changes in the Full-Length NHS Standard Contract 2020/21 relate to:
Improving care in specific clinical services, including:
• Specific changes relating to maternity services, services for children and young people with an eating disorder, and emergency ambulance services; • Requiring compliance with the National Framework for Inter-Facility Transfers; and • Changes to the quality requirements in relation to early intervention in psychosis standards and follow-up in mental health services.
Integrated system working and Primary Care Networks (“PCNs”), including:
• Obligations in relation to the new System Collaboration and Financial Management Agreement; • Requirements for relevant providers of community physical and mental health services that are to have a role in the delivery of the Enhanced Health in Care Homes care model; • Updating existing references to Local System Plans; and • Promoting the alignment of community mental health services with PCNs.
Improving patient safety, including:
• Requiring NHS Trusts and Foundation Trusts to establish a Medical Examiner’s Office and requiring providers to comply with guidance relating to medical examiners; • Replacing the specific requirements relating to use of the Safety Thermometer with a higher-level obligation to ensure and monitor standards of care; • Anticipating changes to the NHS Serious Incident Framework and the Never Events Policy Framework, along with new requirements in relation to the receipt of National Patient Safety Alerts and the designation of Patient Safety Specialists; and • Changes to the quality requirements in relation to infection control.
Promoting other more general improvements in the delivery of care and treatment for patients, including:
• Requiring providers to comply with any EU exit guidance that may be published by the Government, DHSC or NHS England and NHS Improvement; • New obligations requiring co-operation with commissioners to ensure Care and Treatment Reviews are carried out within the applicable timescales; • Changes to when providers may withhold treatment to service users; • Refining the requirements in relation to alcohol advisory and smoking cessation services, and requiring NHS Trusts and Foundation Trusts to use reasonable endeavours to ensure that their premises and grounds are smoke-free; • A new requirement to have regard to guidance when supplying or recommending medication for ongoing use in primary care; • Requiring NHS Trusts and Foundation Trusts to complete the safety and patient experience domains of the NHS Premises Assurance Model and report the findings to their governing body; • More detailed requirements in relation to food standards and ensuring that healthy eating and drinking options are available 24 hours a day; and • Requiring commissioners and providers to agree local activity goals in relation to the interventions covered by the national Evidence-Based Interventions guidance.
Workforce issues relating to staff working in the NHS, including:
• Requiring providers to ensure frontline staff in contact with service users are vaccinated against influenza; • Requiring providers to develop a plan to implement the NHS People Offer in accordance with the NHS People Plan; • Expanding the restrictions on hiring Very Senior Managers who have recently been made redundant by an NHS employer; and • Additional obligations in relation to declarations of interests and complying with Managing Conflicts of Interest in the NHS;
Environmental issues to bring about a greener NHS, including:
• Replacing the general requirement to maintain a sustainable development management plan with more detailed obligations in relation to maintaining and delivering a “Green Plan”, which is to set out how the provider will contribute towards a “Green NHS” with regard to specific commitments in the NHS Long Term Plan; and • Requiring providers to give due regard to the potential to secure wider social, economic and environmental benefits for the local community and population in its purchase and specification of products and services.
The use of technology, booking systems and data in the NHS, including:
• Requiring the parties to comply with their obligations under guidance on the MedTech Funding Mandate; • Obligations on providers of urgent treatment centre services to ensure that their systems enable direct electronic booking of appointments; • Requiring providers to have access to the Health and Social Care Network by 31 August 2020, where applicable; • Requiring providers to have regard to the NHS Internet First Policy and the Code of Conduct for Data-Driven Health and Care Technology when updating, developing or procuring IT systems or software; • Requiring providers to have regard to the NHS Data Sharing Principles; and • Formalising the requirement for providers of A&E and urgent treatment centre services to submit emergency care data sets on a daily basis.
Other technical and minor changes have also been made with a view to making the contract more effective from a practical point of view.
The Shorter-Form version has also been updated to incorporate some, but not all, of the above changes, which reflects its status as the more “light-touch” version.
As with previous updates to the NHS Standard Contract, the changes made in the 2020/21 version will need to be incorporated into existing contracts by way of National Variations. The 2020/21 template National Variations have also been published, which will need to be completed by commissioners and providers for each contract that is based on the NHS Standard Contract. The National Variations will take effect from 1 April 2020. Technical guidance has been published by NHS England to assist with the completion of the National Variations.
NHS England has also published the 2020/21 versions of the NHS Standard Sub-contracts, which have also been updated to reflect the changes made to the NHS Standard Contract.