WIREDGOV

Rise of block contracts risks limiting patient choice

The number of  block contracts commissioned by Clinical Commissioning Groups (CCGs) for NHS-funded elective care procedures has risen by nearly one-third (32%) in one year, to nearly £2.8 billion, according to new data released today by the NHS Partners Network (NHSPN). NHSPN warns that the rise of block contracts threatens the well-established government policy that patients should be enabled to exercise their legal right to choose their healthcare provider for an elective operation.

Block contracts, where CCGs give providers, overwhelmingly NHS Trusts and Foundation Trusts, a set amount of money in advance to deliver a pre-agreed number of operations are often linked to financial pressures, as the guaranteed income helps Trusts to manage their finances. The policy however risks undermining patients’ legal right to choice by incentivising referrals to the provider with the block contract and away from those that rely on patients’ choosing their service. It also risks adding to already growing waiting list problems across the NHS as patients are referred into the default provider and in exceptional circumstances could mean that operations are paid for yet never performed.

David Hare, Chief Executive, NHS Partners Network said:

“A 33% rise in block contracts in just 12 months for routine elective procedures is a clear indication of how much pressure CCGs are under to support the balance sheets of NHS Trusts and Foundation Trusts.

“Whilst block contracts may be tempting for commissioners to agree when public providers are struggling financially they are not better for patients who should be allowed to choose their provider with the money following their decision. The commissioning process needs to reflect the importance of driving up standards in the health service and ultimately improving outcomes for patients.

“We would encourage NHS England and CCGs to reflect on these figures and ensure that decisions around block contracts are carefully balanced between the need to improve patient care and balance the books.” 

The data, collected from an FOI of CCG’s across the country shows:

1. Total value of block contracts has increased by over £700m between 2013/14 to 2015/16 (from £2,032m to £2,778)
2. The total number of block contracts has increased by nearly 50% between 2013 / 14 and 2015 / 16.
3. NHS providers share of block contracts has seen an increase of over 40% between 2013/14 and 2015/16
4. Independent providers’ share of block contracts has dropped by 9.8% in the same period.

Read the full report.