NHS leaders today presented their Five Year Forward View – setting out why and how change is needed over the course of the next 5 years, to better meet the health and care demands of the population. With Twitter and other social media alight with comment and opinion, we at COBIC very much welcome the direction of travel articulated in the forward view, but believe it doesn’t go quite far enough in describing the way in the which the vision can be brought about.
NHS England pledges “different local health communities will be supported by the NHS’ national leadership to choose from amongst a small number of radical new care delivery options, and then given the resources and support to implement them where that makes sense.”
Multi-year capitated outcomes-based incentivised contracts (COBICs) will provide the means to realise the NHS’ vision, as set out today in the Five Year Forward View.
This is because COBICs deliver value and efficiency by creating the conditions in which providers can focus all their efforts on improving outcomes that matter most for individuals, families and communities. COBIC-style contracts enable the NHS to tackle each of the prevention, care and quality, and funding and efficiency gaps identified in the forward view.
By contracting for outcomes, providers are required be able to coordinate care for individuals along pathways and across settings, with services wrapped around the patient. COBIC-style contracts also give some population risk to providers requiring them to develop and implement effective population health management, and, as they are multi-year contracts, they also incentivise prevention – a fundamental focus of the Five Year Forward View. The only way providers can achieve this, and better outcomes for patients, is to come together in new ways that bridge the primary/secondary care divide.
The forward view outlines the intention of the NHS to set up ‘test bed’ sites. Describing that “they would serve as real world sites for ‘combinatorial’ innovations that integrate new technologies, bioinformatics, new staffing models and payment-for-outcomes”. We would like to see that COBIC-style contracting forms part of this initiative.