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, Referral and Booking SC7 Withholding and/or Discontinuation of Service SC8 Unmet Needs and Making Every Contact Count SC9 Consent SC10 Personalised Care Planning and Shared Decision Making SC11 Transfer of and Discharge from Care; Communication with GPs SC12 Communicating With and Involving Service Users, Public and Staff 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 Antimicrobial Resistance and Healthcare Associated Infections SC22 Venous Thromboembolism SC23 Service User Health Records
SC24 NHS 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 People and Death of a Service User SC35 Duty of Candour SC36 Payment Terms SC37 Local Quality Requirements and Quality Incentive Schemes SC38 Commissioning for Quality and Innovation (CQUIN) GENERAL CONDITIONS GC1 Definitions and Interpretation GC2 Effective Date and Duration GC3 Service Commencement GC4 Transition Period GC5 Staff GC6 Intentionally Omitted GC7 Intentionally Omitted 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 Identity, Marketing and Promotion GC24 Change in Control GC25 Warranties GC26 Prohibited Acts GC27 Conflicts of Interest and Transparency on and Hospitality GC28 Force Majeure
GC29 Third Party Rights GC30 Entire Contract GC31 Severability GC32 Waiver GC33 Remedies GC34 Exclusion of Partnership GC35 Non-Solicitation GC36 Notices GC37 Costs and Expenses GC38 Counterparts GC39 Governing Law and Jurisdiction CONTRACT This Contract records the agreement between the Commissioners and the Provider and comprises Particulars; the Service Conditions (Full Length); the General Conditions (Full Length), as completed and agreed by the Parties and as varied from time to time in accordance with GC13 (Variations). IN WITNESS OF WHICH the Parties have signed this Contract on the date(s) shown below SIGNED by ………………………………………………………. Signature [INSERT AUTHORISED SIGNATORY’S NAME] for and on behalf of [INSERT COMMISSIONER NAME] ………………………………………………………. Title ………………………………………………………. Date [INSERT AS FOR EACH COMMISSIONER] SIGNED by ………………………………………………………. Signature [INSERT AUTHORISED SIGNATORY’S NAME] for and on behalf of ………………………………………………………. Title ……………………………………………………….
SCHEDULE 2 – THE SERVICES Essential Services Continuity Plan (NHS Trusts only) Insert text locally or state Not Applicable SCHEDULE 2 – THE SERVICES Clinical Networks Insert text locally or state Not Applicable SCHEDULE 2 – THE SERVICES Other Local Agreements, Policies and Procedures Policy Date Weblink Insert text locally or Not Applicable SCHEDULE 2 – THE SERVICES Transition Arrangements
In line with the requirements set out in the National Tariff, insert text and/or attach spreadsheets or documents locally – or state Not Applicable SCHEDULE 3 – PAYMENT Expected Annual Contract Values Commissioner Expected Annual Contract Value (Exclude any expected payments. CQUIN on account payments are set out separately in Table 2 of Schedule 4D, as required under SC38.3.) Insert text and/or attach spreadsheets or documents locally Total SCHEDULE 3 – PAYMENT Timing and Amounts of Payments in First and/or Final Contract Year Insert text and/or attach spreadsheets or documents locally – or state Not Applicable
SCHEDULE 4 – QUALITY REQUIREMENTS Operational Standards Ref Operational Standards Threshold (2016/17) Method of Measurement (2016/17) Consequence of breach Timing of application of consequence Application 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 Service Quality Performance Reports Where the number of Service Users waiting more than 18 weeks at the end of the month exceeds the tolerance permitted by the threshold, £300 in respect of each such Service User above that threshold Monthly Services to which 18 Weeks applies Diagnostic test waiting times E.B.4 Percentage of Service Users waiting 6 weeks or more from Referral for a diagnostic test* Operating standard of no more than 1% Review of Service Quality Performance Reports the number of Service Users waiting 6 weeks or more at the end of the month exceeds the tolerance permitted by the threshold, £200 in respect of each such Service User above that threshold Monthly A CS CR D A&E waits
suspected) waiting no more than two weeks for first outpatient appointment* exceeds the tolerance permitted by the threshold, £200 in respect of each such Service User above that threshold Cancer – 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 Service Quality Performance Reports Where the number of Service Users who have waited more than 31 days during the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each such Service User 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 Service Quality Performance Reports Where the number of Service Users who have waited more than 31 days during the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each such Service User 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 Service Quality Performance Reports Where the number of Service Users who have waited more than 31 days during the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each such Quarterly A CR R
Category A ambulance calls E.B.15.i Percentage of Category A Red 1 ambulance resulting in an emergency response arriving within 8 minutes* Operating standard of 75% Review of Service Quality Performance Reports Where, for the Contract Year as a whole, the number of Red 1 calls where the emergency response did not arrive within 8 minutes exceeds the tolerance permitted by the threshold, £300 in respect of each call above that threshold Annual AM E.B.15.ii Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes* Operating standard of 75% Review of Service Quality Performance Reports Where, for the Contract Year as a whole, the number of Red 2 calls where the emergency response did not arrive within 8 minutes exceeds the tolerance permitted by the threshold, £100 in respect of each call above that threshold** Annual AM E.B.16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes* Operating standard of 95% Review of Service Quality Performance Reports Where, for the Contract Year as a whole, the number of calls where the response did not arrive within 19 minutes exceeds the tolerance permitted by the threshold, £100 in respect of each call above that threshold** Annual AM
Mixed sex accommodation breaches E.B.S.1 Mixed sex accommodation breach* >0 Review of Service Quality Performance Reports £250 per day per Service User affected Monthly A CR MH Cancelled operations E.B.S.2 All Service who have operations cancelled, on or after the day of admission (including the day of surgery), for reasons to be offered another binding date within 28 days, or the Service User’s treatment to be funded at the time and hospital of the Service User’s choice* Number of Service who are not offered another binding date within 28 days >0 Review of Service Quality Performance Reports Non-payment of costs associated with cancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A CR Mental health E.B.S.3 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 Service Quality Performance Reports Where the number of Service Users in the Quarter not followed up within 7 days exceeds the tolerance permitted by the threshold, £200 in respect of each such Service User above that threshold Quarterly MH MHSS In respect of those Operational Standards shown in bold italics, the provisions of SC36.37A apply. clinical
*(as further described in Technical Guidance for Commissioners, available at ) ** (The Co-ordinating Commissioner has discretion to vary the consequence of breach, in agreement with the Provider, where it is appropriate to do so to take account of the operation of a nationally-approved pilot project.) SCHEDULE 4 – QUALITY REQUIREMENTS National Quality Requirements National Quality Requirement Threshold (2016/17) Method of Measurement (2016/17) Consequence of breach Timing of application of consequence Application E.A.S.4 Zero tolerance Staphylococcus aureus* >0 Review of Service Quality Performance Reports £10,000 in respect of each incidence in the relevant month Monthly A E.A.S.5 Minimise of Clostridium difficile* [Insert Baseline Threshold identified for Provider] Review of Service Quality Performance Reports As set out in Schedule 4G, in accordance with applicable Guidance Annual A E.B.S.4 Zero tolerance RTT over 52 weeks for incomplete pathways* >0 Review of Service Quality Performance Reports £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 Service Quality Performance Reports £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 within 15 minutes with none waiting more than 60 minutes* >0 Review of Service Quality Performance Reports £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 Service Quality Performance Reports £20 per event 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 Service Quality Performance Reports £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 waits in A&E not longer than 12 hours* >0 Review of Service Quality Performance Reports £1,000 per incidence in the relevant month Monthly A+E E.B.S.6 No urgent operation should be cancelled for a second time* >0 Review of Service Quality Performance Reports £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 Service Quality Performance Reports Issue of Contract Performance Notice and subsequent process in accordance with GC9 Quarterly A
defined in Contract Technical Guidance Duty of candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident in accordance with Regulation 20 of the 2014 Regulations Review of Service Quality Performance Reports 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 valid NHS Number field in mental health and acute commissioning data sets submitted via SUS, as defined in Contract Technical Guidance 99% Review of 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 A MH MHSS 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 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 A&E Completion of Mental Health Services Data Set ethnicity coding for all Operating standard of 90% Review of Service Quality Performance Reports Where the number of breaches in the month exceeds the tolerance Monthly MH MHSS
Service Users, as defined in Contract Technical Guidance permitted by the threshold, £10 in respect of each excess breach above that threshold 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 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 E.H.4 Early Intervention in Psychosis programmes: the percentage of Service Users experiencing a first episode of psychosis who commenced a package of care within two weeks of referral Operating standard of 50% Review of Service Quality Performance Reports Issue of Contract Performance Notice and subsequent process in accordance with GC9 Quarterly MH MHSS E.H.1 Improving Access to Psychological Therapies (IAPT) programmes: the percentage of Service Users referred to an IAPT programme who are treated within six weeks of referral Operating standard of 75% Review of Service Quality Performance Reports Issue of Contract Performance Notice and subsequent process in accordance with GC9 Quarterly MH MHSS E.H.2 Improving Access to Psychological Therapies (IAPT) programmes: the Operating standard of 95% Review of Service Quality Performance Reports Issue of Contract Performance Notice and Quarterly MH MHSS
percentage of Service referred to an IAPT programme who are treated within 18 weeks of referral subsequent process in accordance with GC9 Full implementation of an effective e-Prescribing system for chemotherapy across all relevant teams within the Provider (other than those dealing with children, teenagers and and young adults) across all tumour sites Failure to produce a robust implementation plan, by 30 June 2016, to achieve full implementation as described under Service Specification B15/S/a Cancer: Chemotherapy (Adult ) by 31 March 2017 Review of Service Quality Performance Reports 5% of the Actual Monthly Value for the Services provided under Service Specification B15/S/a (Cancer: Chemotherapy (Adult) per month, until a robust implementation plan is produced Monthly Where both Specialised Services and Cancer apply Full implementation of an effective e-Prescribing system for chemotherapy across all relevant clinical teams within the Provider dealing with children, teenagers and young adults across all tumour sites Failure to produce a robust implementation plan, by 30 September 2016 to achieve full implementation as described under Service Specification Review of Service Quality Performance Reports 5% of the Actual Monthly Value for the Services provided under Service Specification B15/S/b Cancer: Chemotherapy (Children, Teenagers and Young Adults) per month, until a robust implementation plan is produced Monthly Where both Specialised Services and Cancer apply