SERVICE CONDITIONS SC1 Compliance with the Law and the NHS Constitution SC2 Regulatory Requirements SC3 Service Standards SC4 Co-operation SC5 Commissioner Requested Services/Essential Services SC6 Choice, Referrals and Booking SC7 Withholding and/or Discontinuation of Service SC8 Unmet Needs SC9 Consent SC10 Personalised Care Planning and Shared Decision Making SC11 Transfer of and Discharge from Care SC12 Service User, and Public Involvement SC13 Equity of Access, Equality and Non-Discrimination SC14 Pastoral, Spiritual and Cultural Care SC15 Places of Safety SC16 Complaints SC17 Services Environment and Equipment SC18 Sustainable Development SC19 Food Standards SC20 Service Development and Improvement Plan SC21 HCAI Reduction Plan SC22 Venous Thromboembolism SC23 Service User Health Records SC24 NHS Counter-Fraud and Security Management SC25 Procedures and Protocols
SC26 Clinical Networks, National Audit Programmes and Approved Research Studies SC27 Formulary SC28 Information Requirements SC29 Managing Activity and Referrals SC30 Emergency Preparedness, Resilience and Response SC31 Force Majeure: Service-specific provisions SC32 Safeguarding, Mental Capacity and Prevent SC33 Incidents Requiring Reporting SC34 Care of Dying People and Death of a Service User SC35 Duty of Candour SC36 Payment Terms SC37 Quality Requirements and Quality Incentive Schemes SC38 Commissioning for Quality and Innovation GENERAL CONDITIONS GC1 Definitions and Interpretation GC2 Effective Date and Duration GC3 Service Commencement GC4 Transition Period GC5 GC6 Not used GC7 Partnership Arrangements GC8 Review GC9 Contract Management GC10 Co-ordinating Commissioner and Representatives GC11 Liability and Indemnity GC12 Assignment and Sub-Contracting GC13 Variations GC14 Dispute Resolution GC15 Governance, Transaction Records and Audit GC16 Suspension GC17 Termination GC18 Consequence of Expiry or Termination GC19 Provisions Surviving Termination GC20 Confidential Information of the Parties GC21 Patient Confidentiality, Data Protection, Freedom of Information and Transparency GC22 Intellectual Property GC23 NHS Branding, Marketing and Promotion GC24 Change in Control GC25 Warranties GC26 Prohibited Acts GC27 Conflicts of Interest GC28 Force Majeure GC29 Third Party Rights
4.3 Applicable local standards 5. Applicable quality requirements and CQUIN goals Applicable Quality Requirements (See Schedule 4A-D) Applicable CQUIN goals (See Schedule 4E) 6. Location of Provider Premises The Provider’s Premises are located at: 7. Individual Service User Placement SCHEDULE 2 – THE SERVICES A1. Specialised Services – Derogations from National Service Specifications Insert text locally or state Not Applicable SCHEDULE 2 – THE SERVICES Indicative Activity Plan Insert text locally or state Not Applicable
SCHEDULE 4 – QUALITY REQUIREMENTS Operational Standards Ref Operational Standards Threshold (2015/16) Method of Measurement (2015/16) Consequence of breach Timing of application of consequence Applicable Service Category RTT waiting times for non-urgent treatment E.B.3 Percentage of Service Users on incomplete RTT pathways (yet to start treatment) waiting no more than 18 weeks from Referral Operating standard of 92% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report (Up to and including 30 September 2015) Where the number of breaches at the end of the month exceeds the tolerance permitted by the threshold, £150 in respect of each excess breach above that threshold (With effect from 1 October 2015) Where the number of breaches at the end of the month exceeds the tolerance permitted by the threshold, £300 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies Diagnostic test waiting times
E.B.7 Percentage of Service Users referred urgently with breast symptoms (where cancer was not initially suspected) waiting no more than two weeks for first outpatient appointment Operating standard of 93% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Quarterly A CR R Cancer waits – 31 days E.B.8 Percentage of Service Users waiting no more than one month (31 days) from diagnosis to first definitive treatment for all cancers Operating standard of 96% Review of monthly Service Quality Performance Report the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.9 Percentage of Service Users waiting no more than 31 days for subsequent treatment where that treatment is surgery Operating standard of 94% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.10 Percentage of Service Users waiting no more than 31 days for subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of 98% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R
E.B.11 Percentage of Service Users waiting no more than 31 days for subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R Cancer waits – 62 days E.B.12 Percentage of Service Users waiting no more than two months (62 days) from urgent GP referral to first definitive treatment for cancer Operating standard of 85% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.13 Percentage of Service Users waiting no more than 62 days from referral from an NHS screening service to first definitive treatment for all cancers Operating standard of 90% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R E.B.14 Percentage of Service Users waiting no more than 62 days for first definitive treatment following a consultant’s decision to upgrade the priority of the Service User (all cancers) [Insert as per local determination] Review of monthly Service Quality Performance Report [Insert as per local determination] Quarterly A CR R
SCHEDULE 4 – QUALITY REQUIREMENTS National Quality Requirements National Quality Requirement Threshold (2015/16) Method of Measurement (2015/16) Consequence of breach Timing of application of consequence Applicable Service Category E.A.S.4 Zero tolerance MRSA >0 Review of monthly Service Quality Performance Report £10,000 in respect of each incidence in the relevant month Monthly A E.A.S.5 Minimise rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report As set out in Schedule 4G, in accordance with applicable Guidance Annual A E.B.S.4 Zero tolerance RTT waits over 52 weeks for incomplete pathways >0 Review of monthly Service Quality Performance Report £5,000 per Service User with an incomplete RTT pathway waiting over 52 at the end of the relevant month Monthly Services to which 18 Weeks applies E.B.S.7a All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 30 minutes >0 Review of monthly Service Quality Performance Report £200 per Service User waiting over 30 minutes in the relevant month Monthly A+E
E.B.S.7b All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 60 minutes >0 Review of monthly Service Quality Performance Report £1,000 per Service User waiting over 60 minutes (in total, not aggregated with E.B.S.7a consequence) in the relevant month Monthly A+E E.B.S.8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes and no longer than 30 minutes >0 Review of monthly Service Quality Performance Report £20 per where > 30 minutes in the relevant month Monthly AM E.B.S.8b Following handover between ambulance and A & E, ambulance crew should be to accept new calls within 15 minutes and no longer than 60 minutes >0 Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with E.B.S.8a consequence) in the relevant month Monthly AM E.B.S.5 Trolley in A&E not longer than 12 hours >0 Review of monthly Service Quality Performance Report £1,000 per incidence in the relevant Monthly A+E E.B.S.6 No urgent operation should be cancelled for a second time >0 Review of monthly Service Quality Performance Report £5,000 per incidence in the relevant month Monthly A CR VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE, as 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect Monthly A
defined in Contract Technical Guidance of each excess breach above that threshold Publication of Formulary Continuing failure to publish Publication on Provider’s website Withholding of up to 1% of the Actual Monthly Value per month until publication Monthly A MH MHSS CR R Duty of candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident in accordance with SC35 Review of monthly Service Quality Performance Report Recovery of the cost of the episode of care, or £10,000 if the cost of the episode of care is unknown or indeterminate Monthly All Completion of a NHS Number field in mental health and acute commissioning data sets submitted via SUS, as defined in Contract Technical Guidance 99% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect of each excess breach above that threshold Monthly A MH MHHS Completion of a NHS Number field in A&E commissioning data sets submitted via SUS, as defined in Contract Technical Guidance 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect Monthly A&E
Type of Survey Frequency Method of Reporting Method of Publication Application Friends and Family Test (where required in accordance with FFT Guidance) As required by FFT Guidance As required by FFT Guidance As required by FFT Guidance All Service User Survey [Insert further description locally] All Staff Survey (appropriate NHS staff surveys where required by Staff Survey Guidance) [Other] [insert further description locally] All (not Small Providers) Carer Survey [Insert further description locally] All [Other insert locally]