Gateway No: 00821 Contract Reference DATE OF CONTRACT 23rd December 2014 SERVICE COMMENCEMENT DATE 24th December 2014 CONTRACT TERM 1 Year COMMISSIONERS NHS Bassetlaw CCG (ODS [02Q]) CO-ORDINATING Commissioner NHS Bassetlaw CCG (ODS [02Q]) PROVIDER [ ] Principal and/or registered office address: [ ] CONTENTS PARTICULARS
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 Service User Booking and Choice and Referrals 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 Involvement SC13 Equity of Access, Equality and Non-Discrimination SC14 Pastoral, Spiritual and Cultural Care SC15 Services Environment and Equipment SC16 Places of Safety SC17 Complaints SC18 Service Development and Improvement Plan SC19 HCAI Reduction Plan SC20 Venous Thromboembolism SC21 Not used SC22 Not used 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 and Resilience Including Major Incidents SC31 Force Majeure: Service-specific provisions SC32 Safeguarding SC33 Incidents Requiring Reporting SC34 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 GC16 Suspension GC17 Termination GC18 Consequence of Expiry or Termination GC19 Provisions Surviving Termination GC20 Confidential Information of the Parties GC21 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
SCHEDULE 4 – QUALITY REQUIREMENTS Operational Standards (ONLY WHERE APPLICABLE) Ref Operational Standards Threshold (2014/15) Method of Measurement (2014/15) Consequence of breach Timing of application of consequence Applicable Service Category RTT waiting times for non-urgent treatment CB_B1 Percentage of admitted Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 90% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £400 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies CB_B2 Percentage of Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 95% at specialty (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £100 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies CB_B3 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 Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £100 in respect Monthly Services to 18 Weeks applies non-
of each excess breach above that threshold Diagnostic test waiting times CB_B4 Percentage of Service Users waiting less than 6 weeks from Referral for a diagnostic test Operating standard of >99% 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 of each excess breach above that threshold Monthly A C CR D A&E waits CB_B5 Percentage of A & E attendances where the Service User was admitted, transferred or discharged within 4 hours of their arrival at an A&E department Operating standard of 95% Review of monthly Service Quality Performance Report the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold. To the extent that the number of breaches exceeds 8% of A&E attendances in the relevant month, no further consequence will be applied in respect of the month Monthly A+E U Cancer - 2 week wait CB_B6 Percentage of Service Users referred urgently with suspected cancer by a GP waiting no more 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 Quarterly A CR R
and hospital of the Service User’s choice Mental health CB_B19 Care Programme Approach (CPA): The percentage of Service Users under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Reports 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 MH MHSS National Quality Requirements (ONLY APPLICABLE) National Quality Requirement Threshold (2014/15) Method of Measurement (2014/15) Consequence of breach Monthly or annual application of consequence Applicable Service Category CB_A15 Zero tolerance MRSA >0 Review of monthly Service Quality Performance Report £10,000 in respect of each incidence in the relevant month Monthly A CB_A16 Minimise of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report As set out in Schedule 4 Part G, in accordance with applicable Guidance Annual A CB_S6 Zero tolerance RTT 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 Monthly Services to which 18
weeks at the end of the relevant month Weeks applies CB_S7a 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 CB_S7b 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 CB_S7a consequence) in the relevant month Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes >0 Review of monthly Service Quality Performance Report £20 per event where > 30 minutes in the relevant month Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes >0 Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) in the relevant month Monthly AM CB_S9 Trolley waits in A&E not longer than 12 hours >0 Review of monthly Service Quality Performance Report £1,000 per incidence in the relevant month Monthly A+E CB_S10 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
Completion of a valid 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 of each excess breach above that threshold Monthly A&E Completion of Mental Health Minimum Data Set ethnicity coding for all detained and informal Service Users, as defined in Contract Technical Guidance Operating standard of 90% Review of monthly Service Quality Performance Reports 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 MH MHSS Completion of IAPT Minimum Data Set outcome data for all appropriate Service Users, as defined in Contract Technical Guidance Operating standard of 90% Review of monthly Service Quality Performance Reports 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 MH MHSS
Events (ONLY WHERE APPLICABLE) Never Events Threshold Method of Measurement Never Event Consequence (per occurrence) Applicability Applicable Service Category SURGICAL Wrong site surgery >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Premises A S Wrong implant/prosthesis >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Premises A S Retained foreign object >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Premises A S
MEDICATION Wrongly prepared high-risk injectable medication >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Settings All except PT Maladministration of solutions >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Settings A Wrong route administration of chemotherapy >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Premises A CR Wrong route administration of oral/enteral treatment >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure All Healthcare Settings All except PT
or necessary care in consequence of the Never Event Inappropriate administration of daily oral methotrexate >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All Healthcare Settings All except PT MENTAL HEALTH Suicide rails >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All mental health inpatient premises MH MHSS Escape of a transferred prisoner >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Never Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, £2,000) plus any additional charges incurred by that Commissioner (whether under this Contract or otherwise) for any corrective procedure or necessary care in consequence of the Never Event All medium and high secure mental health inpatient premises MH MHSS GENERAL HEALTHCARE Falls from unrestricted windows >0 Review of reports submitted to NRLS/Serious Incidents reports and monthly Service Quality Performance Report In accordance with Events Guidance, recovery by the Responsible Commissioner of the costs to that Commissioner of the procedure or episode (or, where these cannot be accurately established, All Healthcare Premises All except AM, PT, Ph
December 2014 Claim Form December 2014 Patient Record Form December 2014 GP Notification Letter B1. Provider’s Mandatory Material Sub-Contractors Mandatory Material Sub-Contractor [Name] [Registered Office] [Company number] Service Description Start date/expiry date Processing data – Yes/No Not Applicable B2. Provider’s Permitted Material Sub-Contractors Permitted Material Sub-Contractor [Name] [Registered Office] [Company number] Service Description Start date/expiry date Processing data – Yes/No Not Applicable C. IPR
thresholds that have been breached and any Never Events that have occurred; details of all requirements satisfied; details of, and reasons for, any failure to meet requirements and; the outcome of all Root Cause Analyses and audits performed pursuant to Service Condition 20 (Venous Thromboembolism). All All A CQUIN Performance Report and details of progress towards satisfying any Quality Incentive Scheme Indicators, including details of all Quality Incentive Scheme Indicators satisfied or not satisfied All Monthly report on performance against the HCAI Reduction Plan Monthly All Complaints monitoring report, setting out numbers of complaints received and All