Agreements with Clatterbridge Cancer Centre and Liverpool Hospitals

AuthorityManx Care
Date received2026-02-11
OutcomeAll information sent
Outcome date2026-03-16
Case ID5297406

Summary

A request was made for all agreements between Manx Care and Clatterbridge Cancer Centre or Liverpool Hospitals from 2018 to present, and the authority responded by sending all requested information, including a specific 2023 commissioning contract.

Key Facts

  • Manx Care confirmed that all information requested regarding off-island treatment agreements was sent.
  • A specific contract (Ref: 1707) with Clatterbridge Cancer Centre NHS Foundation Trust was disclosed.
  • The Clatterbridge contract commenced on 1 April 2023 with an initial term of three years.
  • The contract includes provisions for a potential extension of up to 24 months upon mutual agreement.
  • The response included 26 documents totaling 450 pages.

Data Disclosed

  • 2026-03-16
  • 2026-02-11
  • 450
  • 26
  • 01 January 2018
  • 1 April 2023
  • 31 March 2026
  • 24 months
  • 1707
  • 3 years

Original Request

I write to make a request for information under the Freedom of Information Act 2015 (Isle of Man). Please provide copies of any agreements, contracts, memoranda of understanding, service-level agreements, commissioning arrangements, or equivalent documents which were entered into, varied, renewed, or otherwise operative at any time between 01 January 2018 and the present, under which the Isle of Man Department of Health and Social Care and/or Manx Care (or any predecessor body) has arranged for the treatment and/or diagnostic services of Isle of Man patients provided by: The Clatterbridge Cancer Centre NHS Foundation Trust; and Liverpool University Hospitals NHS Foundation Trust. This request includes agreements held directly by the Department of Health and Social Care and/or Manx Care, as well as any agreements held or administered on their behalf by a third-party commissioning, contracting, or support body. This includes, but is not limited to, arrangements relating to oncology, haematology, transplantation, diagnostics, and associated specialist services. For clarity, this request includes (where held): * Any formal written agreements (including contracts, memoranda of understanding, framework agreements, or service-level agreements). * Any variations, extensions, renewals, side letters, schedules, annexes, or appendices to such agreements. * Any documents setting out governance or oversight arrangements, quality assurance or accreditation expectations, clinical responsibility or liability allocation, arrangements for diagnostic testing or laboratory services, and escalation, incident management, serious incident reporting, or duty-of-candour obligations between the parties. * The date ranges during which each agreement was in force. * Any documents describing the financial or commissioning basis for these arrangements (for example, block contracts, per-patient funding, or cross-border reimbursement mechanisms). If the information is held across multiple documents, please provide all documents that together constitute the agreement(s). If any part of this request is considered exempt, please identify the specific exemption relied upon and disclose any non-exempt information in accordance with the Act. Where documents, or parts of documents, are withheld, please provide sufficient particulars to identify the document and the exemption applied. If the Department of Health and Social Care and/or Manx Care does not hold the requested information, please confirm this explicitly. If it would assist processing, I am content for the response to be provided electronically. I look forward to your response within the statutory timeframe.

Data Tables (220)

DATE OF CONTRACT 1 April 2023
SERVICE COMMENCEMENT DATE 1 April 2023
CONTRACT TERM The initial term of this agreement shall be three (3) years, commencing on 1 April 2023 and concluding on 31 March 2026. Upon expiration of the initial term, the parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C
COMMISSIONERS Manx Care (a statutory board of the Isle of Man Government) Noble’s Hospitals Estate Strang Braddan Isle of Man IM4 4RJ
PROVIDER Clatterbridge Cancer Centre NHS Foundation Trust Clatterbridge Road Bebington Wirral CH63 4JY ODS: REN
SERVICE COMMENCEMENT AND CONTRACT TERM
Effective Date See GC2.1 1 April 2023
Expected Service Commencement Date See GC3.1 1 April 2023
Longstop Date See GC4.1 and 17.10.1
Contract Term The initial term of this agreement shall be three (3) years, commencing on 1 April 2023 and concluding on 31 March 2026. The parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C
Commissioner option to extend Contract Term See Schedule 1C, which applies only if YES is indicated here YES By 24 months
Commissioner Notice Period (for termination under GC17.2) 24 months [Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]
Commissioner Earliest Termination Date (for termination under GC17.2) 12 months after the Service Commencement Date [Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]
Provider Notice Period (for termination under GC17.3) 24 months [Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]
Provider Earliest Termination Date (for termination under GC17.3) 12 months after the Service Commencement Date [Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]
SERVICES
Service Categories Service Categories Indicate all categories of service which
the Provider is commissioned to
provide under this Contract.
Note that certain provisions of the Service
Conditions and Annex A to the Service Conditions
apply in respect of some service categories but not
others.
Medical Oncology: Diagnosis, treatment, and management of cancer using chemotherapy, targeted therapy, immunotherapy, and hormonal therapy.
Radiation Oncology Administration of radiation therapy to target and destroy cancer cells while minimizing damage to healthy tissue.
Surgical Oncology Surgical procedures to remove tumours and cancerous tissue, often as part of the primary treatment or to alleviate symptoms.
Support Services Counselling, nutritional support, pain management, physical therapy, and other supportive services to address the physical, emotional, and practical needs of cancer patients.
Multidisciplinary Care Collaboration among oncologists, surgeons, radiation oncologists, nurses, and other specialists to develop individualized treatment plans tailored to each patient's needs.
Radiology and Imaging Diagnostic imaging services such as MRI, CT scans, PET scans, and ultrasound to aid in cancer diagnosis and treatment planning.
Pathology Examination and analysis of tissue samples and body fluids to diagnose cancer and determine its characteristics, such as type, stage, and grade.
Genetic Counselling Evaluation of genetic risk factors for cancer and counselling for individuals and families regarding hereditary cancer syndromes and genetic testing options.
Patient Education and Outreach Educational programs, support groups, and resources for patients and their families to enhance understanding of cancer, treatment options, and coping strategies.
Survivorship Programs Follow-up care and support for cancer survivors, including monitoring for recurrence, managing late effects of treatment, and promoting overall wellness.
This list may not be exhaustive, and the specific services offered by Clatterbridge Cancer Centre may vary and personalised as required for each respective patient.
Service Requirements
Prior Approval Response Time Standard See SC29.25 Not applicable
GOVERNANCE AND REGULATORY
Nominated Mediation Body (where required – see GC14.4) CEDR
Provider’s Nominated Individual
Provider’s Information Governance Lead
Provider’s Data Protection Officer (if required by Data Protection Legislation)
Provider’s Caldicott Guardian
Provider’s Senior Information Risk Owner
Provider’s Accountable Emergency Officer
Provider’s Safeguarding Lead (children) / named professional for safeguarding children
Provider’s Safeguarding Lead (adults) / named professional for safeguarding adults
Provider’s Child Sexual Abuse and Exploitation Lead
Provider’s Mental Capacity and Liberty Protection Safeguards Lead
Provider’s Prevent Lead
Provider’s Freedom To Speak Up Guardian(s)
Provider’s UEC DoS Contact [ ] Email: [ ] Tel: [ ]
Commissioners’ UEC DoS Leads Not Applicable
Provider’s Infection Prevention Lead
Provider’s Health Inequalities Lead
Provider’s Net Zero Lead
Provider’s 2018 Act Responsible Person Not Applicable
Provider’s Wellbeing Guardian (NHS Trusts and Foundation Trusts only)
CONTRACT MANAGEMENT
Addresses for service of Notices See GC36 Commissioner: Manx Care Noble’s Hospital Estate, Strang, Braddan IM4 4RJ Email: Commissioningandcontracts.ManxCare@gov.im Provider: Clatterbridge Cancer Centre NHS Foundation Trust Clatterbridge Road Bebington Wirral CH63 4JY Email: [ ]
Frequency of Review Meetings See GC8.1 Initially Monthly but will be reviewed during the term of this Agreement to a frequency not greater than Quarterly
Commissioner Representative(s) See GC10.3
Provider Representative See GC10.3
Date Document
Description
 Referral Protocol  Clinical Prioritisation Policy
Service name Clatterbridge Cancer Centre services to the Isle of Man
Service specification number N/A
Population and/or geography to be served Residents of the Isle of Man
Service aims and desired outcomes Provision Cancer services to patients referred from the Isle of Man, with access and outcomes on par with those of UK residents accessing the provider’s services.
Service description and location(s) from which it will be delivered This list may not be exhaustive, and the specific services offered by Clatterbridge Cancer Centre may vary and personalised as required for each respective patient. It is expected that the most activity will occur at the Provider’s site(s), but there will be some services where the provider delivers, at least in part, its services within the Isle of Man, either as a visiting clinic, or provided as virtual services or by Manx Care delivering locally with support and guidance from the Provider. Close working relationship and communications with Manx Care’s referring clinicians will be expected, along with ensuring that arrangements for MDTs are clear, timely and inclusive to Manx Care’s clinicians where relevant. Medical Oncology: Diagnosis, treatment, and management of cancer using chemotherapy, targeted therapy, immunotherapy, and hormonal therapy. Radiation Oncology: Administration of radiation therapy to target and destroy cancer cells while minimizing damage to healthy tissue. Surgical Oncology Surgical procedures to remove tumours and cancerous tissue, often as part of the primary treatment or to alleviate symptoms. Support Services Counselling, nutritional support, pain management, physical therapy, and other supportive services to address the physical, emotional, and practical needs of cancer patients. Multidisciplinary Care Collaboration among oncologists, surgeons, radiation oncologists, nurses, and other specialists to develop individualized treatment plans tailored to each patient's needs.
Area Basis 2023/24 £'s Notes
Consultant Time into clinics 6.56 PAs £101,929
Consultant time into MDT’s 3 x each weekly £52,271
(1 x MO, 1 x CO, 1 x HO)
Staff grade time 4 PA’s £33,882
Specialist nurse time 0.5 wte mid-pt Band 7 with on-costs £28,000
Access to Triage hotline and 0.2 wte mid-pt Band 7 with on-costs £19,435
IO service **
Pharmacy Support Mid-pt Band 8A with on-costs £68,420
IT support · Service desk support £60,346
· EPR team support
· e- prescribing system support
· training
Admin support As previous £29,447
Overheads 10% £38,550
Total Telehealth cost £432,281
Total Hotline Activity 2021/22 2022/23 2023/24 (Q1)
Total Hotline Calls: 13,250 12,972 3,568
Total IoM Calls: 236 207 70
% IoM calls: 1.78% 1.60% 1.96%
Annual Budget 23/24 x IOM Activity % £17,644 £15,808 £19,435
Quality Requirement Threshold Method of Measurement Period over which the Requirement is to be achieved Applicable Service Specification
Insert text and/or attach spreadsheet or documents locally in respect of one or more Contract Years or state Not Applicable
Date
Document
Insert text locally or state Not Applicable
Date
Document
Insert text locally or state Not Applicable
Sub-Contractor [Name] [Registered Office] [Company number] Service Description Start date/expiry date Processing Personal Data – Yes/No
If the Sub-Contractor is
processing Personal Data,
state whether the Sub-
Contractor is a Data
Processor OR a Data
Controller OR a joint Data
Controller
Insert text locally or state Not Applicable
Sub-Contractor
[Name]
[Registered Office]
[Company number]
Processing Personal Data
– Yes/No
Commissioner
Role/Responsibility
Not Applicable
Reporting Period Format of Report Timing and Method for Service
delivery of Report category
National Requirements Reported Centrally
1. As specified in the Schedule of Approved Collections published at https://digital.nhs.uk/isce/publication/nhs-standard- contract-approved-collections where mandated for and as applicable to the Provider and the Services As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
1a. Without prejudice to 1 above, daily submissions of timely Emergency Care Data Sets, in accordance with DAPB0092-2062 and with detailed requirements published at https://digital.nhs.uk/data-and-information/data- collections-and-data-sets/data-sets/emergency- care-data-set-ecds/ecds-latest-update As set out in relevant Guidance As set out in relevant Guidance Daily A+E, U
2. Patient Reported Outcome Measures (PROMS) https://digital.nhs.uk/data-and-information/data- tools-and-services/data-services/patient-reported- outcome-measures-proms As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
National Requirements Reported Locally
1a. Activity and Finance Report 1a. Activity and Finance Report Monthly In the format specified in the relevant Information Standards Notice (DCB2050) [For local agreement] A, MH
1b. Activity and Finance Report Monthly [For local agreement] [For local agreement] All except A, MH
2. Service Quality Performance Report, detailing Monthly [For local agreement] Within 15 Operational Days of the end of the month to which it relates All All
performance against National Quality
Requirements, Local Quality Requirements and
the duty of candour, including, without limitation:
a. details of any thresholds that have been
breached and breaches in respect of the
duty of candour that have occurred;
b. details of all requirements satisfied;
Reporting Period Format of Report Timing and Method for Service
delivery of Report category
c. details of, and reasons for, any failure to All
meet requirements
3. Complaints monitoring report, setting out [For local agreement] [For local agreement] [For local agreement] All
numbers of complaints received and including
analysis of key themes in content of complaints
4. Report against performance of Service In accordance with relevant SDIP In accordance with relevant SDIP In accordance with relevant SDIP All
Development and Improvement Plan (SDIP)
5. Summary report setting out relevant information Monthly [For local agreement] [For local agreement] All
on Patient Safety Incidents and the progress of
and outcomes from Patient Safety Investigations,
as agreed with the Commissioner
6. Data Quality Improvement Plan: report of In accordance with relevant DQIP In accordance with relevant DQIP In accordance with relevant DQIP All
progress against milestones
7. Report on outcome of reviews and evaluations in relation to Staff numbers and skill mix in accordance with GC5.2 (Staff) 7. Report on outcome of reviews and evaluations in Annually (or more frequently if and as required by the Commissioner from time to time) [For local agreement] [For local agreement] All
relation to Staff numbers and skill mix in
accordance with GC5.2 (Staff)
8. Report on its performance against the National Annually [For local agreement] By 31 October in each Contract Year; submission to Commissioner All
Workforce Race Equality Standard and action
plan setting out the steps the Provider will take to
improve performance
9. (If the Provider is an NHS Trust or an NHS Annually [For local agreement] By 31 October in each Contract Year; submission to Commissioner All
Foundation Trust) report on its performance
against the National Workforce Disability Equality
Standard and action plan setting out the steps the
Provider will take to improve performance
10. Where the Services include Specialised Services As set out at https://www.england.nhs. uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.nh s.uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.nh s.uk/nhs-standard- contract/dc-reporting/ All
and/or other services directly commissioned by
NHS England (or commissioned by an ICB,
where NHS England has delegated the function
of commissioning those services), specific reports
as set out at
https://www.england.nhs.uk/nhs-standard-
contract/dc-reporting/
(where not otherwise required to be submitted as
a national requirement reported centrally or
locally)
11. Report on progress against Green Plan in Annually [For local agreement] [For local agreement] All
Reporting Period Format of Report Timing and Method for Service
delivery of Report category
accordance with SC18.2 (NHS Trust/FT only)
Local Requirements Reported Locally
12. SLAMs and PLDS and any other associated activity and performance reports related to Manx Care’s patients under the care of the Provider. Monthly [For local agreement] The Provider must submit any patient- identifiable data required in relation to Local Requirements Reported Locally via the Data Landing Portal in accordance with the Data Landing Portal Acceptable Use Statement. [Otherwise, for local agreement] Reports to be sent to: ManxCareBI@gov.im In accordance to SUS timetable All
12. SLAMs and PLDS and any other associated
activity and performance reports related to Manx
Care’s patients under the care of the Provider.
Data Quality Indicator Data Quality Threshold Method of Measurement Milestone Date
Not Applicable
Milestones Timescales Expected Benefit
Not Applicable
Type of Survey Frequency Method of Reporting Method of Publication
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
National Quarterly Pulse Survey (NQPS) (if the Provider is an NHS Trust or an NHS Foundation Trust) As required by NQPS Guidance As required by NQPS Guidance As required by NQPS Guidance
[Other insert locally (for example, Service User Survey, Carer Survey]
Description Details
Commissioner for which Data Processing Services are to be performed Manx Care
Subject matter of the processing Provision of specialized acute and tertiary services, including elective and non-elective cases for referred by Manx Care / Isle of Man
Duration of the processing 1 April 2023 until contract end date.
Nature and purposes of the processing The processing involves the collection, recording, organisation, and provision of specialized healthcare services for patients referred by Manx Care. The purposes include medical treatment, diagnostics, patient care management, and maintaining health records in accordance with statutory obligations.
Type of Personal Data Patient information, including but not limited to: name, address, date of birth, medical history, diagnostic data, treatment plans, and any other relevant medical information necessary for the provision of healthcare services
Categories of Data Subject Patients (and their guardians) referred by Manx Care for specialized healthcare services.
Plan for return and destruction of the data once the processing is complete UNLESS requirement under law to preserve that type of data Data will be retained for the duration of the treatment and for a period minimum of 8 years after the conclusion of treatment or 25 years in the case of records relating to the treatment of children. Upon completion of the processing, the data will be securely returned to the Commissioner or destroyed in accordance with applicable data protection laws and regulations. If there is a legal requirement to preserve certain types of data, the Provider will notify the Commissioner and specify the reasons for the extended retention period.
Manx Care
Noble's Hospital Estate
Strang
Braddan
IM4 4RJ
PROVISION OF SERVICES
SC1 Compliance with the Law and the NHS Constitution 1.1 The Provider must provide the Services in accordance with the Fundamental Standards of Care and the Service Specifications. The Provider must perform all of its obligations under this Contract in accordance with: 1.1.1 the terms of this Contract; 1.1.2 the Law; and 1.1.3 Good Practice. The Provider must, when requested by the Commissioner, provide evidence of the development and updating of its clinical process and procedures to reflect Good Practice.
1.2 The Commissioner must perform all of their obligations under this Contract in accordance with: 1.2.1 the terms of this Contract; 1.2.2 the Law; and 1.2.3 Good Practice.
1.3 The Parties must abide by and promote awareness of the NHS Constitution, including the rights and pledges set out in it. The Provider must ensure that all Sub- Contractors and all Staff abide by the NHS Constitution.
1.4 In performing their respective obligations under this Contract, each Party must have due regard to the Armed Forces Covenant and the Armed Forces Duty Statutory Guidance.
SC2 Regulatory Requirements 2.1 The Provider must: 2.1.1 comply, where applicable, with the registration and regulatory compliance guidance of any relevant Regulatory or Supervisory Body; 2.1.2 respond to all applicable requirements and enforcement actions issued from time to time by any relevant Regulatory or Supervisory Body; 2.1.3 comply, where applicable, with the standards and recommendations issued from time to time by any relevant Regulatory or Supervisory Body;
2.1.4 consider and respond to the recommendations arising from any audit, clinical outcome review programme, Serious Incident investigation report, Patient Safety Incident investigation report or other patient safety related review process; 2.1.5 comply with the standards and recommendations issued from time to time by any relevant professional body and agreed in writing between the Commissioner and the Provider; 2.1.6 comply, where applicable, with the recommendations contained in NICE Technology Appraisals and have regard to other Guidance issued by NICE from time to time; 2.1.7 respond to any reports and recommendations made by Local Healthwatch; and 2.1.8 meet its obligations under Law in relation to the production and publication of Quality Accounts.
2.2 The Parties must comply, where applicable, with their respective obligations under, and with recommendations contained in, MedTech Funding Mandate Guidance.
SC3 Service Standards 3.1 The Provider must: 3.1.1 not breach the thresholds in respect of the National Quality Requirements; and 3.1.2 not breach the thresholds in respect of the Local Quality Requirements.
3.2A A failure by the Provider to comply with SC3.1 will be excused if it is directly attributable to or caused by an act or omission of the Commissioner, but will not be excused if the failure was caused primarily by an increase in Referrals.
3.2B Not Used
3.3 If the Provider does not comply with SC3.1 the Commissioner may, in addition and without affecting any other rights that it may have under this Contract: 3.3.1 issue a Contract Performance Notice under GC9.4 (Contract Management) in relation to the breach or failure; and/or 3.3.2 take action to remove any Service User affected from the Provider’s care; and/or
3.3.3 if it reasonably considers that there may be further non-compliance of that nature in relation to other Service Users, take action to remove those Service Users from the Provider’s care.
3.4 The Provider must continually review and evaluate the Services, must act on insight derived from those reviews and evaluations, from feedback, complaints, audits, clinical outcome review programmes, Patient Safety Incidents, and from the involvement of Service Users, Staff, GPs, Referrers and the public (including the outcomes of Surveys), and must demonstrate at Review Meetings the extent to which Service improvements have been made as a result and how these improvements have been communicated to Service Users, their Carers, GPs and the public.
3.5 The Provider must implement policies and procedures for reviewing deaths of Service Users whilst under the Provider’s care and for engaging with bereaved families and Carers.
3.6 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must comply with National Guidance on Learning from Deaths where applicable.
3.7 The Provider must: 3.7.1 if it is an NHS Trust or an NHS Foundation Trust (and except as otherwise agreed with the National Medical Examiner), establish and operate a Medical Examiner Office; and 3.7.2 comply with Medical Examiner Guidance as applicable.
3.8 The Provider must co-operate fully with the Commissioner and the original Referrer in any re-referral of the Service User to another provider (including providing Service User Health Records, other information relating to the Service User’s care and clinical opinions if reasonably requested). Any failure to do so will constitute a material breach of this Contract.
3.9 If a Service User is admitted for acute Elective Care services and the Provider cancels that Service User’s operation after admission for non-clinical reasons, the terms of the NHS Constitution Handbook cancelled operations pledge will apply.
3.10 The Provider (whether or not it is required to be CQC registered for the purpose of the Services) must identify and give notice to the Commissioner of the name, address and position in the Provider of the Nominated Individual.
3.11 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must assess its performance using the Board Assurance Framework for Seven Day Hospital Services as required by Guidance and must share a copy of each assessment with the Commissioner.
3.12 Where the Provider provides vascular surgery Services, hyper-acute stroke Services, major trauma Services, STEMI heart attack Services or children’s critical care Services, the Provider must ensure that those Services comply in full with Seven Day Service Hospital Priority Clinical Standards.
3.13 Not Used
3.14 In performing its obligations under this Contract, the Provider (if it is an NHS Trust or an NHS Foundation Trust) must have regard to Learning Disability Improvement Standards.
3.15 Not Used .
3.16 The Commissioner and the Provider must jointly assess, by no later than 30 September in each Contract Year, the effectiveness of their arrangements for managing the interface between the Services and local primary medical services, including the Provider’s compliance with SC8.2-5, SC11.5-7, SC11.9-10, SC11.12 and SC12.2 of this Contract.
3.17 Following the assessment undertaken under SC3.16, the Commissioner and the Provider must then: 3.17.1 agree, at the earliest opportunity, an action plan to address any deficiencies their assessment identifies, ensuring that this action plan is informed by discussion with the Referrer 3.17.2 arrange for the action plan to be approved in public by each of their Governing Bodies and to be shared with the Referrer
3.17.3 in conjunction with the Commissioner, implement the action plan diligently, keeping the relevant Referrer informed of progress with its implementation.
3.18 The Provider (if it is not an NHS Trust or an NHS Foundation Trust) must have regard to the Medical Practitioners Assurance Framework.
3.19 The Provider must nominate a 2018 Act Responsible Person and must ensure that the Commissioner is kept informed at all times of the identity of the person holding that position. The Provider must comply, and must ensure that its 2018 Act Responsible Person complies, with their respective obligations under the 2018 Act and 2018 Act Guidance.
3.20 The Provider must, by no later than 31 March 2024, implement a system of early screening, risk assessment and health optimisation for all adult Service Users waiting for inpatient surgery, in accordance with the requirements on perioperative care co-ordination set out in the Elective Recovery Plan.
SC4 Co-operation 4.1 The Parties must at all times act in good faith towards each other and in the performance of their respective obligations under this Contract.
4.2 The Parties must co-operate in accordance with the Law and Good Practice to facilitate the delivery of the Services in accordance with this Contract, having regard at all times to the welfare and rights of Service Users.
4.3 The Provider and each Commissioner must, in accordance with Law, Good Practice and any guidance issued by the Secretary of State under sections 72 and 82 of the 2006 Act regarding the duty to co-operate, co-operate fully and share information with each other and with any other commissioner or provider of health or social care in respect of a Service User in order to: 4.3.1 ensure that a consistently high standard of care for the Service User is maintained at all times; 4.3.2 ensure that high quality, integrated and co-ordinated care for the Service User is delivered across all pathways spanning more than one provider; 4.3.3 achieve continuity of service that avoids inconvenience to, or risk to the health and safety of, the Service User, employees of the Commissioner or members of the public; and 4.3.4 seek to ensure that the Services and other health and social care services delivered to the Service User are delivered in such a way as to maximise value for public money, optimise allocation of resources and minimise unwarranted variations in quality and outcomes.
4.4 The Provider must ensure that its provision of any service to any third party does not hinder or adversely affect its delivery of the Services or its performance of this Contract.
4.5 Not Used
4.6 In performing their respective obligations under this Contract the Parties must have regard to, and support each other to observe and promote, health services stated strategic objectives of improving outcomes in population health and healthcare, tackling inequalities in outcomes, experience and access, enhancing productivity and value for money, and supporting broader social and economic development, through active involvement in the work of the relevant community.
4.7 Not Used
4.8 Not Used
4.9 Not Used
4.10 Not Used
SC5 Commissioner Requested Services/Essential Services 5.1 The Provider must comply with its obligations under the Provider Licence in respect of any Services designated as CRS by any Commissioner from time to time in accordance with CRS Guidance.
5.2 The Provider (if it is an NHS Trust) must maintain its ability to provide, and must ensure that it is able to offer to the Commissioner, any Essential Services.
5.3 The Provider (if it is an NHS Trust) must have and at all times maintain an up-to- date Essential Services Continuity Plan in respect of any Essential Services. The Provider must provide a copy of any updated Essential Services Continuity Plan to the Commissioner within 5 Operational Days following any update.
5.4 The Provider (if it is an NHS Trust) must, in consultation with the Commissioner, implement any applicable Essential Services Continuity Plan as required: 5.4.1 if there is any interruption to the Provider’s ability to provide the Essential Services; 5.4.2 if there is any partial or entire suspension of the Essential Services; or 5.4.3 on expiry or early termination of this Contract or of any Service for any reason (and this obligation will apply both before and after expiry or termination).
SC6 Choice and Referral 6.1 The Parties must comply with their respective obligations under NHS e-Referral Guidance and Guidance issued by the Department of Health and Social Care and NHS England regarding patients’ rights to choice of provider and/or Consultant or Healthcare Professional, including the NHS Choice Framework.
6.2 The Provider must describe and publish all acute GP Referred Services in the NHS e-Referral Service through a Directory of Service, offering choice of any clinically appropriate team led by a named Consultant or Healthcare Professional as applicable. In relation to all such GP Referred Services: 6.2.1 the Provider must ensure that all such Services are able to receive Referrals through the NHS e-Referral Service; 6.2.2 the Provider must, in respect of Services which are Directly Bookable: 6.2.2.1 use all reasonable endeavours to make sufficient appointment slots available within the NHS e-Referral Service to enable any Service User to book an appointment for a GP Referred Service within a reasonable period via the NHS e-Referral Service; and
6.2.2.2 ensure that it has arrangements in place to accept Referrals via the NHS e-Referral Service where the Service User or Referrer has not been able to book a suitable appointment, ensuring that it has safe systems in place for offering appointments promptly where this occurs; 6.2.3 the Provider must offer clinical advice and guidance to GPs and other primary care Referrers: 6.2.3.1 on potential Referrals, through the NHS e-Referral Service; and/or 6.2.3.2 on potential Referrals and on the care of Service Users generally, as otherwise set out in the Service Specifications, whether this leads to a Referral being made or not. The price payable by each Commissioner for such advice and guidance will be either: 6.2.3.2.1 deemed to be included in the Fixed Payment set out in Schedule 3A (Aligned Payment and Incentive Rules), or 6.2.3.2.2 the Local Price as set out in Schedule 3C (Local Prices), as appropriate; 6.2.4 the Commissioner must use all reasonable endeavours to ensure that in respect of all Referrals by GPs and other primary care Referrers the Provider is given accurate Service User contact details and all pertinent information required by relevant local Referral protocols in accordance with the PRSB Clinical Referral Information Standard; 6.2.5 the Commissioner must use all reasonable endeavours to ensure that all Referrals by GPs are made through the NHS e-Referral Service; and 6.2.6 each Commissioner must take the necessary action, as described in NHS e-Referral Guidance, to ensure that all GP Referred Services are available to their local Referrers within the NHS e-Referral Service.
6.3 Subject to the provisions of NHS e-Referral Guidance: 6.3.1 the Provider need not accept Referrals by GPs to Consultant-led acute outpatient Services made other than through the NHS e-Referral Service; 6.3.2 the Provider must implement a process through which the non- acceptance of a Referral under this SC6.3 will, in every case, be communicated without delay to the Service User’s GP, so that the GP can take appropriate action; and 6.3.3 each Commissioner must ensure that GPs within its area are made aware of this process.
6.4 Not Used
6.4A This SC6.4A applies to all acute GP Referred Services and to all other Services which the Provider chooses to list within the NHS e-Referral Service. The Provider must, having consulted all relevant Commissioner, ensure that each Service to which this SC6.4A applies and each site from which that Service will be delivered is listed on the correct menu within the NHS e-Referral Service, so that: 6.4A.1 each Service to which the legal right to choice applies, as set out in the NHS Choice Framework, and each site from which that Service will be delivered, is listed on the Secondary Care Menu; and 6.4A.2 all other Services and the sites from which those Services will be delivered are listed in the Primary Care Menu.
6.5 The Provider must make the specified information available to prospective Service Users through the NHS Website, and must in particular use the NHS Website to promote awareness of the Services among the communities it serves, ensuring the information provided is accurate, up-to-date, and complies with the provider profile policy set out at www.nhs.uk.
18 Weeks Information 6.6 In respect of Consultant-led Services to which the 18 Weeks Referral-to- Treatment Standard applies: 6.6.1 the Provider must ensure that the confirmation to the Service User of their first outpatient appointment includes the 18 Weeks Information; and 6.6.2 the Provider must publish on its website and operate a Local Access Policy complying with the requirements of the Commissioner.
6.7 Not used.
Acceptance and Rejection of Referrals 6.8 Subject to SC6.3 and to SC7 (Withholding and/or Discontinuation of Service), the Provider must: 6.8.1 accept any Referral of a Service User made in accordance with the Referral processes and clinical thresholds set out or referred to in this Contract and/or as otherwise agreed between the Parties and/or as specified in any Prior Approval Scheme, and in any event where necessary for a Service User to exercise their legal right to choice as set out in the NHS Choice Framework; and 6.8.2 (subject to SC6.13.1) accept any clinically appropriate referral for any Service of an individual whose Commissioner is not a Party to this Contract where necessary for that individual to exercise their legal right to choice as set out in the NHS Choice Framework; and 6.8.3 where it can safely do so, accept a referral or presentation for emergency treatment, within the scope of the Services, of or by any individual whose Commissioner is not a Party to this Contract. Any referral or presentation as referred to in SC6.8.2 or 6.8.3 will not be a Referral under this Contract and the relevant provisions of the Contract Technical Guidance will apply in respect of it.
6.9 Not Used
6.10 Not Used
6.11 Not Used
6.12 Not Used
6.13 The existence of this Contract does not entitle the Provider to accept referrals in respect of, provide services to, nor to be paid for providing services to, individuals whose Commissioner is not a Party to this Contract, except: 6.13.1 where such an individual is exercising their legal right to choice as set out in the NHS Choice Framework, and then only if: 6.13.1.1 the service provided to that individual is a Service as described in this Contract; and 6.13.1.2 where this Contract otherwise identifies a site or sites at which or a geographical area within which the Service is to be delivered, the service provided to that individual is delivered from such a site or within that geographical area, as appropriate; or 6.13.2 where necessary for that individual to receive emergency treatment.
Urgent and Emergency Care Directory of Services 6.14 Not Used
6.15 Not Used
SC7 Withholding and/or Discontinuation of Service 7.1 Nothing in this SC7 allows the Provider to refuse to provide or to stop providing a Service if that would be contrary to the Law.
7.2 The Provider will not be required to provide or to continue to provide a Service to a Service User: 7.2.1 who in the Provider’s reasonable professional opinion is unsuitable to receive the relevant Service, for as long as they remain unsuitable; 7.2.2 in respect of whom no valid consent (where required) has been given in accordance with the Service User consent policy; 7.2.3 who displays abusive, violent or threatening behaviour unacceptable to the Provider, or behaviour which the Provider determines constitutes discrimination or harassment towards any Staff or other Service User (within the meaning of the Equality Act 2010) (the Provider in each case acting reasonably and taking into account that Service User’s mental health and clinical presentation and any other health conditions which may influence their behaviour); 7.2.4 in that Service User’s domiciliary care setting or circumstances (as applicable) where that environment poses a level of risk to the Staff engaged in the delivery of the relevant Service that the Provider reasonably considers to be unacceptable; or 7.2.5 where expressly instructed not to do so by an emergency service provider who has authority to give that instruction, for as long as that instruction applies.
7.3 If the Provider proposes not to provide or to stop providing a Service to any Service User under SC7.2: 7.3.1 where reasonably possible, the Provider must explain to the Service User, Carer or Legal Guardian (as appropriate), taking into account any communication or language needs, the action that it is taking, when that action takes effect, and the reasons for it (confirming that explanation in writing within 2 Operational Days); 7.3.2 the Provider must tell the Service User, Carer or Legal Guardian (as appropriate) that they have the right to challenge the Provider’s decision through the Provider’s complaints procedure and how to do so; 7.3.3 wherever possible, the Provider must inform the relevant Referrer (and if the Service User’s GP is not the relevant Referrer, subject to obtaining consent in accordance with Law and Guidance, the Service User’s GP) in writing without delay before taking the relevant action; and
7.3.4 the Provider must liaise with the Commissioner and the relevant Referrer to seek to maintain or restore the provision of the relevant care to the Service User in a way that minimises any disruption to the Service User’s care and risk to the Service User.
7.4A Except in respect of Services to which SC7.4B, SC7.4C or SC7.4D applies: 7.4A1 If the Provider, the Commissioner and the Referrer cannot agree on the continued provision of the relevant Service to a Service User, the Provider must (subject to any requirements under SC11 (Transfer of and Discharge from Care; Communication with GPs)) notify the Commissioner (and where applicable the Referrer) that it will not provide or will stop providing the Service to that Service User. 7.4A2 The Commissioner must then liaise with the Referrer to procure alternative services for that Service User.
7.4B Not Used
7.4C Not Used
7.4D Not Used
7.5 If the Provider stops providing a Service to a Service User under SC7.2, and the Provider has complied with SC7.3, the Commissioner must pay the Provider in accordance with SC36 (Payment Terms) for the Service provided to that Service User before the discontinuance.
SC8 Unmet Needs, Making Every Contact Count and Self Care 8.1 If the Provider believes that a Service User or a group of Service Users may have an unmet health or social care need, it must notify the Commissioner accordingly. The Commissioner will be responsible for making an assessment to determine any steps required to be taken to meet those needs.
8.2 If the Provider considers that a Service User has an immediate need for treatment or care which is within the scope of the Services it must notify the Service User, Carer or Legal Guardian (as appropriate) of that need without delay and must provide the required treatment or care in accordance with this Contract, acting at all times in the best interest of the Service User. The Provider must notify the Service User’s GP as soon as reasonably practicable of the treatment or care provided.
8.3 If the Provider considers that a Service User has an immediate need for care which is outside the scope of the Services, it must notify the Service User, Carer or Legal Guardian (as appropriate) and the Service User’s GP of that need without delay and must co-operate with the Referrer to secure the provision to the Service User of the required treatment or care, acting at all times in the best interests of the Service User. In fulfilling its obligations under this SC8.3, the Provider must ensure that it takes account of all available information relating to the relevant locally-available services (including information held in the UEC DoS).
8.4 If the Provider considers that a Service User has a non-immediate need for treatment or care which is within the scope of the Services and which is directly related to the condition or complaint which was the subject of the Service User’s original Referral or presentation, it must notify the Service User, Carer or Legal Guardian (as appropriate) of that need without delay and must (unless referral back to the Service User’s GP is required in order for the Provider to comply with its obligations under SC29.4.1) provide the required treatment or care in accordance with this Contract, acting at all times in the best interest of the Service User. The Provider must notify the Service User’s GP as soon as reasonably practicable of the treatment or care provided.
8.5 Except as permitted under an applicable Prior Approval Scheme, the Provider must not carry out, nor refer to another provider to carry out, any non-immediate or routine treatment or care that is not directly related to the condition or complaint
which was the subject of the Service User’s original Referral or presentation without the agreement of the Service User’s GP.
8.6 The Provider must develop and maintain an organisational plan to ensure that Staff use every contact that they have with Service Users and the public as an opportunity to maintain or improve health and wellbeing, in accordance with the principles and using the tools comprised in Making Every Contact Count Guidance.
8.7 In accordance with the Alcohol and Tobacco Brief Interventions Guidance, the Provider must screen inpatient Service Users for alcohol and tobacco use and, where appropriate: 8.7.1 offer brief advice or interventions to Service Users; and/or 8.7.2 refer the Service User to available alcohol advisory and/or smoking cessation services provided by the relevant Local Authority; and/or 8.7.3 if the Provider is an NHS Trust or an NHS Foundation Trust, refer the Service User to an appropriate NHS Smoking Cessation Advance Service.
8.8 Where clinically appropriate, the Provider must support Service Users to develop the knowledge, skills and confidence to take increasing responsibility for managing their own ongoing care.
8.9 Not Used
SC9 Consent 9.1 The Provider must publish, maintain and operate a Service User consent policy which complies with Good Practice and the Law.
SC10 Personalised Care 10.1 In the performance of their respective obligations under this Contract the Parties must (where and as applicable to the Services): 10.1.1 give due regard to Guidance on Personalised Care; and 10.1.2 use all reasonable endeavours to implement any Development Plan for Personalised Care.
10.2 The Provider must comply with regulation 9 of the 2014 Regulations. In planning and reviewing the care or treatment which a Service User receives, the Provider must employ Shared Decision-Making, using supporting tools and techniques approved by the Commissioner.
10.3 Where required by Guidance, the Provider must, in association with other relevant providers of health and social care, 10.3.1 develop and agree a Personalised Care and Support Plan with the Service User and/or their Carer or Legal Guardian; and 10.3.2 ensure that the Service User and/or their Carer or Legal Guardian (as appropriate) can access that Personalised Care and Support Plan in a format and through a medium appropriate to their needs.
10.4 The Provider must prepare, evaluate, review and audit each Personalised Care and Support Plan on an on-going basis. Any review must involve the Service User and/or their Carer or Legal Guardian (as appropriate).
10.5 The Provider must use all reasonable endeavours to ensure that, when arranging an outpatient or community appointment in relation to any Service (subject to the requirements of the Service Specification and where clinically appropriate), it offers the Service User the option of a telephone or video appointment, or any other available remote consultation option, as an alternative to a face-to-face consultation.
10.6 Where the Provider provides outpatient Services, it must have regard to Guidance on Implementing Patient Initiated Follow-up.
10.7 Where a Local Authority requests the cooperation of the Provider in securing an Education, Health and Care Needs Assessment, the Provider must use all reasonable endeavours to comply with that request within 6 weeks of the date on which it receives it.
SC11 Transfer of and Discharge from Care; Communication with GPs 11.1 The Provider must comply with: 11.1.1 the Transfer of and Discharge from Care Protocols; 11.1.2 Not Used; 11.1.3 Not Used; 11.1.4 Not Used 11.1.5 the 2014 Act and the Care and Support (Discharge of Hospital Patients) Regulations 2014; and 11.1.6 Transfer and Discharge Guidance and Standards.
11.2 The Provider and each Commissioner must use its best efforts to support safe, prompt discharge from hospital and to avoid circumstances and transfers and/or discharges likely to lead to emergency readmissions or recommencement of care.
11.3 Before the transfer of a Service User to another Service under this Contract and/or before a Transfer of Care or discharge of a Service User, the Provider must liaise as appropriate with any relevant third party health or social care provider, and with the Service User and any Legal Guardian and/or Carer, to prepare and agree a Care Transfer Plan. The Provider must implement the Care Transfer Plan when delivering the further Service, or transferring and/or discharging the Service User, unless (in exceptional circumstances) to do so would not be in accordance with Good Practice.
11.4 A Commissioner may agree a Shared Care Protocol in respect of any clinical pathway with the Provider and representatives of local primary care and other providers. Where there is a proposed Transfer of Care and a Shared Care Protocol is applicable, the Provider must, where the Service User’s GP has confirmed willingness to accept the Transfer of Care, initiate and comply with the Shared Care Protocol.
11.5 When transferring or discharging a Service User from an inpatient or day case or accident and emergency Service, the Provider must within 24 hours following that transfer or discharge issue a Discharge Summary to the Service User’s GP and/or Referrer and to any relevant third party provider of health or social care, using the applicable Delivery Method. The Provider must ensure that it is at all times able to send and receive Discharge Summaries via all applicable Delivery Methods.
11.6 When transferring or discharging a Service User from a Service which is not an inpatient or day case or accident and emergency Service, the Provider must, if required by the relevant Transfer of and Discharge from Care Protocol, issue the Discharge Summary to the Service User’s GP and/or Referrer and to any relevant third party provider of health or social care within the timescale, and in accordance with any other requirements, set out in that protocol.
11.6A Not Used
11.7 Where, in the course of delivering an outpatient Service to a Service User, the Provider becomes aware of any matter or requirement pertinent to that Service User’s ongoing care and treatment which would necessitate the Service User’s GP taking prompt action, the Provider must communicate this by issue of a Clinic Letter to the Service User’s GP. The Provider must send the Clinic Letter as soon as reasonably practicable and in any event within 7 days following the Service User’s outpatient attendance. The Provider must issue such Clinic Letters using the applicable Delivery Method.
11.8 The Commissioner must use all reasonable endeavours to assist the Provider to access the necessary national information technology systems to support electronic submission of Discharge Summaries and Clinic Letters and to ensure that GPs are in a position to receive Discharge Summaries and Clinic Letters via the Delivery Method applicable to communication with GPs.
11.9 Where a Service User has a clinical need for medication to be supplied on discharge from inpatient or day case care, the Provider must ensure that the Service User will have on discharge an adequate quantity of that medication to last: 11.9.1 for the period required by local practice, in accordance with any requirements set out in the Transfer of and Discharge from Care Protocols (but at least 7 days); or 11.9.2 (if shorter) for a period which is clinically appropriate. The Provider must supply that quantity of medication to the Service User itself, except to the extent that the Service User already has an adequate quantity and/or will receive an adequate supply via an existing repeat prescription from the Service User’s GP or other primary care provider.
11.10 Where a Service User has an immediate clinical need for medication to be supplied following outpatient clinic attendance, the Provider must itself supply to the Service User an adequate quantity of that medication to last for the period required by local practice, in accordance with any requirements set out in the
Transfer of and Discharge from Care Protocols (but at least sufficient to meet the Service User’s immediate clinical needs until the Service User’s GP receives the relevant Clinic Letter and can prescribe accordingly).
11.11 The Parties must at all times have regard to NHS Guidance on Prescribing Responsibilities, including, in the case of the Provider, in fulfilling its obligations under SC11.4, 11.9 and/or 11.10 (as appropriate). When supplying medication to a Service User under SC11.9 or SC11.10 and/or when recommending to a Service User’s GP any item to be prescribed for that Service User by that GP following discharge from inpatient care or clinic attendance, the Provider must have regard to Guidance on Prescribing in Primary Care.
11.12 Where a Service User either: 11.12.1 is admitted to hospital under the care of a member of the Provider’s medical Staff; or 11.12.2 is discharged from such care; or 11.12.3 attends an outpatient clinic or accident and emergency service under the care of a member of the Provider’s medical Staff, the Provider must, where appropriate under and in accordance with Fit Note Guidance, issue free of charge to the Service User or their Carer or Legal Guardian any necessary medical certificate to prove the Service User’s fitness or otherwise to work, covering the period until the date by which it is anticipated that the Service User will have recovered or by which it will be appropriate for a further clinical review to be carried out.
11.13 The Provider must use all reasonable endeavours to refer Service Users, on discharge from inpatient care and where clinically appropriate, into the NHS Discharge Medicines Service, in accordance with the NHS Discharge Medicine Service Toolkit as applicable to the Provider.
11.14 The Parties must comply with their respective obligations under the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care and must co-operate with each other, with the relevant Local Authority and with other providers of health and social care as appropriate, to minimise the number of NHS Continuing Healthcare assessments which take place in an acute hospital setting.
SC12 Communicating with and Involving Service Users, Public and Staff 12.1 The Provider must: 12.1.1 arrange and carry out all necessary steps in a Service User’s care and treatment promptly and in a manner consistent with the relevant Service Specifications and Quality Requirements until such point as the Service User can appropriately be discharged in accordance with the Transfer of and Discharge from Care Protocols;
12.1.2 ensure that Staff work effectively and efficiently together, across professional and Service boundaries, to manage their interactions with Service Users so as to ensure that they experience co-ordinated, high quality care without unnecessary duplication of process; 12.1.3 notify the Service User (and, where appropriate, their Carer and/or Legal Guardian) of the results of all investigations and treatments promptly and in a readily understandable, functional, clinically appropriate and cost effective manner; and 12.1.4 communicate in a readily understandable, functional and timely manner with the Service User (and, where appropriate, their Carer and/or Legal Guardian), their GP and other providers about all relevant aspects of the Service User’s care and treatment.
12.2 The Provider must: 12.2.1 provide Service Users (in relation to their own care) and Referrers (in relation to the care of an individual Service User) with clear information in respect of each Service about who to contact if they have questions about their care and how to do so; 12.2.2 ensure that there are efficient arrangements in place in respect of each Service for responding promptly and effectively to such questions and that these are publicised to Service Users and Referrers using all appropriate means, including appointment and admission letters and on the Provider’s website; and 12.2.3 wherever possible, deal with such questions from Service Users itself, and not by advising the Service User to speak to their Referrer.
12.3 The Provider must comply with the Accessible Information Standard.
12.4 The Provider must actively engage, liaise and communicate with Service Users (and, where appropriate, their Carers and Legal Guardians), Staff, GPs and the public in an open, clear and accessible manner in accordance with the Law and Good Practice, seeking their feedback whenever practicable. In communicating with a Service User (and, where appropriate, their Carer and/or Legal Guardian), the Provider must have regard to their health literacy in order to support them to make informed decisions about the Service User’s health, care and wellbeing.
12.5 The Provider must involve Service Users (and, where required by Law or otherwise appropriate, their Carers and Legal Guardians), Staff, Service Users’ GPs and the public when considering and implementing developments to and redesign of Services. As soon as reasonably practicable following any reasonable request by the Commissioner, the Provider must provide evidence of that involvement and of how the views of those involved have been taken account of in the relevant developments to and redesign of Services.
12.6 The Provider must: 12.6.1 carry out the Friends and Family Test Surveys as required in accordance with FFT Guidance, using all reasonable endeavours to maximise the number of responses from Service Users; 12.6.2 (if it is an NHS Trust or an NHS Foundation Trust) carry out the National Quarterly Pulse Survey as required in accordance with National Quarterly Pulse Survey Guidance; 12.6.3 carry out Staff Surveys which must, where required by Staff Survey Guidance, include the appropriate NHS staff surveys; 12.6.4 carry out all other Surveys; and 12.6.5 co-operate with any surveys that the Commissioner (acting reasonably) carry out. The form, frequency and reporting of the Surveys will be as set out in Schedule 6D (Surveys) or as otherwise agreed between the Commissioner and the Provider in writing and/or required by Law or Guidance from time to time.
12.7 The Provider must review and provide a written report to the Commissioner on the results of each Survey. The report must identify any actions reasonably required to be taken by the Provider in response to the Survey. The Provider must implement those actions as soon as practicable. The Provider must publish the outcomes of and actions taken in relation to all Surveys.
SC13 Equity of Access, Equality and Non-Discrimination 13.1 The Parties must not discriminate between or against Service Users, Carers or Legal Guardians on the grounds of age, disability, gender reassignment, marriage or civil partnership, pregnancy or maternity, race, religion or belief, sex, sexual orientation, or any other non-medical characteristics, except as permitted by Law.
13.2 The Provider must provide appropriate assistance and make reasonable adjustments for Service Users, Carers and Legal Guardians who do not speak, read or write English or who have communication difficulties (including hearing, oral or learning impairments). The Provider must carry out an annual audit of its compliance with this obligation and must demonstrate at Review Meetings the extent to which Service improvements have been made as a result.
13.3 In performing its obligations under this Contract the Provider must comply with the obligations contained in section 149 of the Equality Act 2010, the Equality Act 2010 (Specific Duties) Regulations and section 6 of the HRA. If the Provider is not a public authority for the purposes of those sections and regulations it must comply with them as if it were.
13.4 In consultation with the Commissioner, and on reasonable request, the Provider must provide a plan setting out how it will comply with its obligations under SC13.3. If the Provider has already produced such a plan in order to comply with the Law, the Provider may submit that plan to the Commissioner in order to comply with this SC13.4.
13.5 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must implement EDS.
13.6 The Provider must: 13.6.1 in accordance with Schedule 6A (Reporting Requirements), submit to the Commissioner an annual report on its performance against the National Workforce Race Equality Standard and an action plan setting out any steps it will take to improve its performance, in each case in a form previously approved by the Provider’s Governing Body; and 13.6.2 at the same time publish both the report and the action plan on its website.
13.7 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must ensure that it has in place effective procedures intended to prevent unlawful discrimination in the recruitment and promotion of Staff and must publish: 13.7.1 a five-year action plan, showing how it will ensure that the black, Asian and minority ethnic representation a) among its Staff at Agenda for Change Band 8a and above, and b) on its Governing Body will, by the end of that period, reflect the black, Asian and minority ethnic representation in its workforce, or in its local community, whichever is the higher; and 13.7.2 regular reports on its progress in implementing that action plan and in achieving its bespoke targets for black, Asian and minority ethnic representation amongst its Staff, as described in the NHS Model Employer Strategy.
13.8 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must: 13.8.1 in accordance with Schedule 6A (Reporting Requirements), submit to the Commissioner an annual report on its performance against the National Workforce Disability Equality Standard and an action plan setting out any steps it will take to improve its performance, in each case in a form previously approved by the Provider’s Governing Body; and 13.8.2 at the same time publish both the report and the action plan on its website.
13.9 In performing its obligations under this Contract, the Provider must use all reasonable endeavours to: 13.9.1 support the Commissioner in carrying out their duties under the 2006 Act in respect of the reduction of inequalities in access to health services and in the outcomes achieved from the delivery of health services; and 13.9.2 implement any Health Inequalities Action Plan.
13.10 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must nominate a Health Inequalities Lead and ensure that the Commissioner is kept informed at all times of the person holding this position.
SC14 Pastoral, Spiritual and Cultural Care 14.1 The Provider must take account of the spiritual, religious, pastoral and cultural needs of Service Users.
14.2 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must have regard to NHS Chaplaincy Guidelines.
SC15 Urgent Access to Mental Health Care 15.1 The Parties must have regard to the Mental Health Crisis Care Concordat and must reach agreement on the identification of, and standards for operation of, Places of Safety in accordance with the Law, the 1983 Act Code and the Royal College of Psychiatrists Standards.
15.2 The Parties must co-operate to ensure that individuals under the age of 18 with potential mental health conditions are referred for, and receive, age-appropriate assessment, care and treatment in accordance with the 1983 Act.
15.3 The Parties must use all reasonable endeavours to ensure that, where an individual under the age of 18 requires urgent mental health assessment, care or treatment, that individual is not: 15.3.1 held in police custody in a cell or station; or 15.3.2 admitted to an adult inpatient service (unless this is clinically appropriate in line with the requirements of the 1983 Act); or 15.3.3 admitted to an acute paediatric ward (unless this is required in accordance with NICE guideline CG16 (Self-harm in over 8s) or if the individual has an associated physical health or safeguarding need).
15.4 The Parties must use all reasonable endeavours to ensure that, where an individual under the age of 18 requiring urgent mental health assessment, care or treatment attends or is taken to an accident and emergency department: 15.4.1 a full biopsychosocial assessment is undertaken and an appropriate care plan is put in place; and 15.4.2 the individual is not held within the accident and emergency department beyond the point where the actions in SC15.4.1 have been completed.
SC16 Complaints 16.1 The Commissioner and the Provider must each publish, maintain and operate a complaints procedure in compliance with the Fundamental Standards of Care and other Law and Guidance.
16.2 The Provider must: 16.2.1 provide clear information to Service Users, their Carers and representatives, and to the public, displayed prominently in the Services Environment as appropriate, on how to make a complaint or to provide other feedback and on how to contact Local Healthwatch; and 16.2.2 ensure that this information informs Service Users, their Carers and representatives, of their legal rights under the NHS Constitution, how they can access independent support to help make a complaint, and how they can take their complaint to the Health Service Ombudsman should they remain unsatisfied with the handling of their complaint by the Provider.
SC17 Services Environment and Equipment 17.1 The Provider must: 17.1.1 ensure that the Services Environment and the Equipment comply with the Fundamental Standards of Care; and 17.1.2 comply with National Standards of Healthcare Cleanliness.
17.2 Unless stated otherwise in this Contract, the Provider must at its own cost provide all Equipment necessary to provide the Services in accordance with the Law and any necessary Consents.
17.3 The Provider must ensure that all Staff using Equipment, and all Service Users and Carers using Equipment independently as part of the Service User’s care or treatment, have received appropriate and adequate training and have been assessed as competent in the use of that Equipment.
17.4 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must comply with the requirements of Health Building Note 00-08 in relation to advertising of legal services.
17.5 Without prejudice to SC17.4, the Provider (if it is an NHS Trust or an NHS Foundation Trust) must not enter into, extend or renew any contractual arrangement under which a Legal Services Provider is permitted to provide, promote, arrange or advertise any legal service to Service Users, their relatives, Carers or Legal Guardians, whether: 17.5.1 at the Provider’s Premises; or 17.5.2 on the Provider’s website; or 17.5.3 through written material sent by the Provider to Service Users, their relatives, Carers or Legal Guardians, if and to the extent that that legal service would or might relate to or lead to the pursuit of a claim against the Provider, any other provider or any commissioner of NHS services.
17.6 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must use all reasonable endeavours to ensure that no Legal Services Provider makes any unsolicited approach to any Service User or their relatives, Carer or Legal Guardian while at the Provider’s Premises.
17.7 The Provider must ensure that supplies of appropriate sanitary products are available and are, on request, provided promptly to inpatient Service Users free of charge.
17.8 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must use reasonable endeavours to ensure that the Provider’s Premises are Smoke-free at all times.
17.9 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must complete the NHS Premises Assurance Model and submit a report to its Governing Body in accordance with the requirements and timescales set out in the NHS Premises Assurance Model, and make a copy available to the Commissioner on request.
17.10 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must comply, where applicable, with NHS Car Parking Guidance, and in particular must ensure that any car parking facilities at the Provider’s Premises for Service Users, visitors and Staff are available free of charge to those groups and at those times identified in, and otherwise in accordance with, that guidance.
17.11 In relation to any inpatient, outpatient, accident and emergency or diagnostic Services which it provides, the Provider must operate a clinically appropriate policy for visits to, and accompaniment of, Service Users which is no more restrictive that the position described in National Principles on Hospital Visiting.
SC18 Green NHS and Sustainability 18.1 In performing its obligations under this Contract the Provider must take all reasonable steps to minimise its adverse impact on the environment and to deliver the commitments set out in Delivering a ‘Net Zero’ National Health Service.
18.2 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must maintain and deliver a Green Plan, approved by its Governing Body, in accordance with Green Plan Guidance and must: 18.2.1 provide an annual summary of progress on delivery of that plan to the Commissioner; 18.2.2 nominate a Net Zero Lead and ensure that the Commissioner is kept informed at all times of the person holding this position; and 18.2.3 publish in its annual report quantitative progress data, covering as a minimum greenhouse gas emission in tonnes, emissions reduction projections and an overview of the Provider’s strategy to deliver those reductions.
18.3 The Provider must have in place clear, detailed plans as to how it will contribute towards a ‘Green NHS’ with regard to Delivering a ‘Net Zero’ National Health Service commitments in relation to: 18.3.1 air pollution, and specifically how it will: 18.3.1.1 take action to reduce air pollution from fleet vehicles, transitioning as quickly as reasonably practicable to use exclusively Zero and Ultra-Low Emission Vehicles; 18.3.1.2 take action to phase out fossil fuels for primary heating and replace them with less polluting alternatives; 18.3.1.3 develop and operate expenses policies for Staff which promote sustainable travel choices; 18.3.1.4 ensure that any car leasing schemes for Staff (including salary sacrifice schemes) exclude High Emission Vehicles and promote Zero and Ultra-Low Emission Vehicles; and 18.3.1.5 develop plans to install electric vehicle charging infrastructure for fleet vehicles at the Provider’s Premises;
18.3.2 climate change, and specifically how it will take action: 18.3.2.1 to reduce greenhouse gas emissions from the Provider’s Premises in line with targets in Delivering a ‘Net Zero’ National Health Service; 18.3.2.2 in accordance with Good Practice, to reduce the carbon impacts from the use, or atmospheric release, of environmentally damaging gases such as nitrous oxide and fluorinated gases used as anaesthetic agents and as propellants in inhalers, reducing piped nitrous oxide waste, by clinically appropriate prescribing of lower greenhouse gas emitting inhalers, and by encouraging Service Users to return their inhalers to pharmacies for appropriate disposal; 18.3.2.3 in complying with SC18.3.2.2 above, to reduce appropriately the proportion of desflurane to all volatile gases used in surgery to 2% or less by volume across 2023/24 as a whole (with a view to eliminating use of desflurane altogether, except as permitted by Guidance, with effect from 31 March 2024); and 18.3.2.4 to adapt the Provider’s Premises and the manner in which Services are delivered to reduce risks associated with climate change and severe weather; and 18.3.3 single use plastic products and waste, and specifically how it will take action: 18.3.3.1 to reduce waste and water usage through best practice efficiency standards and adoption of innovations; 18.3.3.2 to reduce avoidable use of single use plastic products; and 18.3.3.3 to make provision with a view to maximising the rate of return of walking aids for re-use or recycling, and must implement those plans diligently.
18.4 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must ensure that, as far as reasonably feasible, all electricity it purchases is from Renewable Sources.
18.5 The Provider must, in performing its obligations under this Contract: 18.5.1 give due regard to the potential to secure wider social, economic and environmental benefits for the local community and population in its purchase and specification of products and services, and must discuss and seek to agree with the Commissioner, and review on an annual basis, which impacts it will prioritise for action and
18.5.2 (if it is an NHS Trust or an NHS Foundation Trust), when procuring goods, services and/or works, comply with the requirements set out in the NHS Net Zero Supplier Roadmap.
SC19 National Standards for Healthcare Food and Drink 19.1 The Provider must comply with the National Standards for Healthcare Food and Drink, as applicable.
RECORDS AND REPORTING
SC20 Service Development and Improvement Plan 20.1 The Commissioner and the Provider must agree an SDIP where required by and in accordance with Guidance.
20.2 The Commissioner and the Provider may at any time agree an SDIP.
20.3 Any SDIP must be appended to this Contract at Schedule 6C (Service Development and Improvement Plans). The Commissioner and Provider must comply with their respective obligations under any SDIP. The Provider must report performance against any SDIP in accordance with Schedule 6A (Reporting Requirements).
SC21 Infection Prevention and Control and Staff Vaccination 21.1 The Provider must: 21.1.1 comply with the Code of Practice on the Prevention and Control of Infections and put in place and implement an infection prevention programme in accordance with it; 21.1.2 if it is an NHS Trust or an NHS Foundation Trust, implement by no later than 31 March 2024, and thereafter comply with, the National Infection Prevention and Control Manual; 21.1.3 if it is not an NHS Trust or an NHS Foundation Trust, have regard to the National Infection Prevention and Control Manual; 21.1.4 nominate an Infection Prevention Lead and ensure that the Commissioner is kept informed at all times of the person holding this position; 21.1.5 have regard to NICE guideline NG15 (Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use); and
21.1.6 have regard to the Antimicrobial Stewardship Toolkit for English Hospitals.
21.2 The Provider must ensure that all laboratory services (whether provided directly or under a Sub-Contract) comply with the UK Standards for Microbiology Investigations.
21.3 The Provider (if it is an NHS Trust or an NHS Foundation Trust) must use all reasonable endeavours, consistent with good practice, to reduce its Broad- Spectrum Antibiotic Usage (measured against the Broad-Spectrum Antibiotic Usage 2017 Baseline) by 10% by 31 March 2024.
21.4 The Provider must use all reasonable endeavours to ensure that all eligible frontline Staff in contact with Service Users are vaccinated, in accordance with JCVI and Green Book Guidance, against influenza and Covid-19.
21.5 The Provider must use all reasonable endeavours to ensure that, where Staff have any contact with a Service User who is either immunosuppressed and/or pregnant (other than while that Service User is an inpatient), they provide that Service User with brief advice on Covid-19 vaccination, in accordance with JCVI and Green Book Guidance, including on available routes for accessing a vaccination service.
SC22 Assessment and Treatment for Acute Illness 22.1 The Provider must implement the methodology described in NEWS 2 Guidance for assessment of acute illness severity for adult Service Users, ensuring that each adult Service User is monitored at the intervals set out in that guidance and that in respect of each adult Service User an appropriate clinical response to their NEW Score, as defined in that guidance, is always effected.
22.2 The Provider must comply with Sepsis Implementation Guidance.
SC23 Service User Health Records 23.1 The Provider must accept transfer of, create and maintain Service User Health Records as appropriate for all Service Users. The Provider must securely store, retain and destroy those records in accordance with Data Guidance, Records Management Code of Practice for Health and Social Care and in any event in accordance with Data Protection Legislation.
23.2 The Provider must: 23.2.1 if and as so reasonably requested by a Commissioner, whether during or after the Contract Term, promptly deliver to any third party provider of healthcare or social care services nominated by that Commissioner a
copy of the Service User Health Record held by the Provider for any Service User for whom that Commissioner is responsible; and 23.2.2 notwithstanding SC23.1, if and as so reasonably requested by a Commissioner at any time following the expiry or termination of this Contract, promptly deliver to any third party provider of healthcare or social care services nominated by that Commissioner, or to the Commissioner itself, the Service User Health Record held by the Provider for any Service User for whom that Commissioner is responsible.
23.3 The Provider must give each Service User full and accurate information regarding their treatment and must evidence that in writing in the relevant Service User Health Record.
NHS Number 23.4 Subject to and in accordance with Law and Guidance the Provider must: 23.4.1 ensure that the Service User Health Record includes the Service User’s verified NHS Number; 23.4.2 use the NHS Number as the consistent identifier in all clinical correspondence (paper or electronic) and in all information it processes in relation to the Service User; and 23.4.3 be able to use the NHS Number to identify all Activity relating to a Service User; and 23.4.4 use all reasonable endeavours to ensure that the Service User’s verified NHS Number is available to all clinical Staff when engaged in the provision of any Service to that Service User.
23.5 The Commissioner must ensure that each Referrer (except a Service User presenting directly to the Provider for assessment and/or treatment) uses the NHS Number as the consistent identifier in all correspondence in relation to a Referral.
Information Technology Systems 23.6 Subject to GC21 (Patient Confidentiality, Data Protection, Freedom of Information and Transparency) the Provider must ensure that all Staff involved in the provision of urgent, emergency and unplanned care are able to view key Service User clinical information from GP records, whether via the Summary Care Records Service or a locally integrated electronic record system supplemented by the Summary Care Records Service.
23.7 The Provider must ensure that (subject to GC21 (Patient Confidentiality, Data Protection, Freedom of Information and Transparency)) all of its major clinical information technology systems enable clinical data to be accessible to other providers of services to Service Users as structured information through open
interfaces in accordance with Open API Policy and Guidance and Care Connect APIs.
23.8 The Provider must ensure that its information technology systems comply with DCB0160 in relation to clinical risk management.
Internet First and Code of Conduct 23.9 When updating, developing or procuring any information technology system or software, the Provider must have regard to the NHS Internet First Policy and the Code of Conduct for Data-Driven Health and Care Technology.
Urgent Care Data Sharing Agreement 23.10 The Provider must enter into an Urgent Care Data Sharing Agreement with the Commissioner and such other providers of urgent and emergency care services as the Commissioner may specify, consistent with the requirements of GC21 (Patient Confidentiality, Data Protection, Freedom of Information and Transparency) and otherwise on such terms as the Commissioner may reasonably require.
Health and Social Care Network 23.11 The Provider must, where applicable, have appropriate access to the Health and Social Care Network and have terminated any remaining N3 services.
SC24 NHS Counter-Fraud Requirements 24.1 The Provider must put in place and maintain appropriate measures to prevent, detect and investigate fraud, bribery and corruption, having regard to NHSCFA Requirements.
24.2 If the Provider: 24.2.1 is an NHS Trust; and/or 24.2.2 holds a Provider Licence (unless required to do so solely because it provides CRS as designated by the Commissioner or any other commissioner), it must take the necessary action to meet NHSCFA Requirements, including in respect of reporting via the NHS fraud case management system.
24.3 If requested by the Commissioner, or NHSCFA or any Regulatory or Supervisory Body, the Provider must allow a person duly authorised to act on behalf of NHSCFA, on behalf of any Regulatory or Supervisory Body or on behalf
of any Commissioner to review, in line with the NHSCFA Requirements, the counter-fraud measures put in place by the Provider.
24.4 The Provider must implement any reasonable modifications to its counter-fraud arrangements required by a person referred to in SC24.3 in order to meet the NHSCFA Requirements within whatever time periods as that person may reasonably require.
24.5 On becoming aware of any suspected or actual bribery, corruption or fraud involving NHS-funded services, the Provider must promptly report the matter to its nominated Local Counter Fraud Specialist and to NHSCFA.
24.6 On the request of the Department of Health and Social Care, NHS England, NHSCFA, any Regulatory or Supervisory Body or the Commissioner, the Provider must allow NHSCFA or any Local Counter Fraud Specialist nominated by a Commissioner, as soon as it is reasonably practicable and in any event not later than 5 Operational Days following the date of the request, access to: 24.6.1 all property, premises, information (including records and data) owned or controlled by the Provider; and 24.6.2 all Staff who may have information to provide, relevant to the detection and investigation of cases of bribery, fraud or corruption, directly or indirectly in connection with this Contract.
SC25 Other Local Agreements, Policies and Procedures 25.1 If requested by the Commissioner or the Provider, the Commissioner or the Provider (as the case may be) must within 5 Operational Days following receipt of the request send or make available to the other copies of any Services guide or other written agreement, policy, procedure or protocol implemented by any Commissioner or the Provider (as applicable).
25.2 The Commissioner must notify the Provider and the Provider must notify the Commissioner of any material changes to any items it has disclosed under SC25.1.
25.3 The Parties must comply with their respective obligations under the documents contained or referred to in Schedule 2G (Other Local Agreements, Policies and Procedures).
SC26 Clinical Networks, National Audit Programmes and Approved Research Studies 26.1 The Provider must: 26.1.1 participate in the Clinical Networks, programmes and studies listed in Schedule 2F (Clinical Networks); 26.1.2 participate in: 26.1.2.1 any national programme within the National Clinical Audit and Patient Outcomes Programme; 26.1.2.2 any other national clinical audit or clinical outcome review programme managed or commissioned by HQIP; and 26.1.2.3 any national programme included within the NHS England Quality Accounts List for the relevant Contract Year, relevant to the Services; and 26.1.3 make national clinical audit data available to support national publication of Consultant-level activity and outcome statistics in accordance with HQIP Guidance.
26.2 The Provider must adhere to all protocols and procedures operated or recommended under the programmes and arrangements referred to in SC26.1, unless in conflict with existing protocols and procedures agreed between the Parties, in which case the Parties must review all relevant protocols and procedures and try to resolve that conflict.
26.3 The Provider must put arrangements in place to facilitate recruitment of Service Users and Staff as appropriate into Approved Research Studies.
26.4 If the Provider chooses to participate in any Commercial Contract Research Study which is submitted to the Health Research Authority for approval, the Provider must ensure that that participation will be in accordance with the National Directive on Commercial Contract Research Studies, at a price determined by NIHR for each Provider in accordance with the methodology prescribed in the directive and under such other contractual terms and conditions as are set out in the directive.
26.5 The Provider must comply with HRA/NIHR Research Reporting Guidance, as applicable.
26.6 The Parties must comply with NHS Treatment Costs Guidance, as applicable.
SC27 Formulary 27.1 Where any Service involves or may involve the prescribing of drugs, the Provider must: 27.1.1 ensure that its current Formulary is published and readily available on the Provider’s website; 27.1.2 ensure that its Formulary reflects all relevant positive NICE Technology Appraisals; and 27.1.3 make available to Service Users all relevant treatments recommended in positive NICE Technology Appraisals.
SC28 Information Requirements 28.1 The Parties acknowledge that the submission of complete and accurate data in accordance with this SC28 is necessary to support the commissioning of all health and social care services in England.
28.2 The Provider must: 28.2.1 provide the information specified in this SC28 and in Schedule 6A (Reporting Requirements): 28.2.1.1 with the frequency, in the format, by the method and within the time period set out or referred to in Schedule 6A (Reporting Requirements); and 28.2.1.2 as detailed in relevant Guidance; and 28.2.1.3 if there is no applicable time period identified, in a timely manner; 28.2.2 where and to the extent applicable, conform to all NHS information standards notices, data provision notices and information and data standards approved or published by the Secretary of State, NHS England or NHS Digital; 28.2.3 implement any other datasets and information requirements agreed from time to time between it and the Commissioner; 28.2.4 comply with Data Guidance issued by NHS England and NHS Digital and with Data Protection Legislation in relation to protection of patient identifiable data; 28.2.5 subject to and in accordance with Law and Guidance and any relevant standards issued by the Secretary of State, NHS England or NHS Digital, use the Service User’s verified NHS Number as the consistent identifier of each record on all patient datasets;
28.2.6 comply with the Data Guidance and Data Protection Legislation on the use and disclosure of personal confidential data for other than direct care purposes; and 28.2.7 use all reasonable endeavours to optimise its performance under the Data Quality Maturity Index (where applicable) and must demonstrate its progress to the Commissioner on an ongoing basis, through agreement and implementation of a Data Quality Improvement Plan or through other appropriate means.
28.3 The Commissioner may request from the Provider any information in addition to that to be provided under SC28.2 which any Commissioner reasonably and lawfully requires in relation to this Contract. The Provider must supply that information in a timely manner.
28.4 The Commissioner must act reasonably in requesting the Provider to provide any information under this Contract, having regard to the burden which that request places on the Provider, and may not, without good reason, require the Provider: 28.4.1 to supply any information to any Commissioner locally where that information is required to be submitted centrally under SC28.2; or 28.4.2 where information is required to be submitted in a particular format under SC28.2, to supply that information in a different or additional format (but this will not prevent the Commissioner from requesting disaggregation of data previously submitted in aggregated form); or 28.4.3 to supply any information to any Commissioner locally for which that Commissioner cannot demonstrate purpose and value in connection with the discharge of that Commissioner’s statutory duties and functions.
28.5 The Provider and each Commissioner must ensure that any information provided to any other Party in relation to this Contract is accurate and complete.
Counting and coding of Activity 28.6 The Provider must ensure that each dataset that it provides under this Contract contains the ODS code and/or other appropriate identifier for the relevant Commissioner. The Parties must have regard to Commissioner Assignment Methodology Guidance and Who Pays? Guidance when determining the correct Commissioner code in activity datasets.
28.7 The Parties must at all times comply with Guidance relating to clinical coding published by NHS Digital or NHS England and with the definitions of Activity maintained under the NHS Data Model and Dictionary.
28.8 Where NHS England issues new or updated Guidance on the counting and coding of Activity and that Guidance requires the Provider to change its counting and coding practice, the Provider must: 28.8.1 as soon as reasonably practicable inform the Commissioner in writing of the change it is making to effect the Guidance; and 28.8.2 implement the change on the date (or in the phased sequence of dates) mandated in the Guidance.
28.9 Where any change in counting and coding practice required under SC28.8 is projected, once implemented, to have, or is found following implementation to have had, an impact on the Actual Annual Value of Services, the Parties must adjust the relevant Prices payable, 28.9.1 where the change is to be, or was, implemented within the Contract Year in which the relevant Guidance was issued by NHS Digital or NHS England, in respect of the remainder of that Contract Year; and 28.9.2 in any event, in respect of the whole of the Contract Year following the Contract Year in which the relevant Guidance was issued by NHS Digital or NHS England, in accordance with the NHS Payment Scheme to ensure that that impact is rendered neutral for that Contract Year or those Contract Years, as applicable.
28.10 Except as provided for in SC28.8, the Provider must not implement a change of practice in the counting and coding of Activity without the agreement of the Commissioner.
28.11 Either the Commissioner or the Provider may at any time propose a change of practice in the counting and coding of Activity to render it compliant with Guidance issued by NHS Digital or NHS England already in effect. The Party proposing such a change must give the other Party written notice of the proposed change at least 6 months before the date on which that change is proposed to be implemented.
28.12 The Party receiving notice of the proposed change of practice under SC28.11 must not unreasonably withhold or delay its agreement to the change.
28.13 Any change of practice proposed under SC28.11 and agreed under SC28.12 must be implemented on 1 April of the following Contract Year, unless the Parties agree a different date (or phased sequence) for its implementation.
28.14 Where any change in counting and coding practice proposed under SC28.11 and agreed under SC28.12 is projected, once implemented, to have, or is found following implementation to have had, an impact on the Actual Annual Value, the Parties must adjust the relevant Prices payable:
28.14.1 where the change is to be, or was, implemented within the Contract Year in which the change was proposed, in respect of the remainder of that Contract Year; and 28.14.2 in any event, in respect of the whole of the Contract Year following the Contract Year in which the change was proposed, in accordance with the NHS Payment Scheme to ensure that that impact is rendered neutral for that Contract Year or those Contract Years, as applicable.
28.15 Where any change of practice in the counting and coding of Activity is implemented, the Provider and the Commissioner must, working jointly and in good faith, use all reasonable endeavours to monitor its impact and to agree the extent of any adjustments to Prices which may be necessary under SC28.9 or SC28.14.
Aggregation and disaggregation of information 28.16 Information to be provided by the Provider under this SC28 and Schedule 6A (Reporting Requirements) and which is necessary for the purposes of SC36 (Payment Terms) must be provided: 28.16.1 to the Commissioner in aggregate form; and/or 28.16.2 directly to each Commissioner in disaggregated form relating to its own use of the Services, as the Commissioner may direct.
SUS 28.17 The Provider must submit commissioning data sets to SUS in accordance with SUS Guidance, where applicable. Where SUS is applicable, if: 28.17.1 there is a failure of SUS; or 28.17.2 there is an interruption in the availability of SUS to the Provider or to any Commissioner, the Provider must comply with Guidance issued by NHS England and/or NHS Digital in relation to the submission of the national datasets collected in accordance with this SC28 pending resumption of service, and must submit those national datasets to SUS as soon as reasonably practicable after resumption of service.
Information Breaches 28.18 If the Commissioner becomes aware of an Information Breach it must notify the Provider accordingly. The notice must specify: 28.18.1 the nature of the Information Breach; and
28.18.2 the sums (if any) which the Commissioner intends to withhold, under SC28.19 if the Information Breach is not rectified within 5 Operational Days following service of that notice.
28.19 If the Information Breach is not rectified within 5 Operational Days of the date of the notice served in accordance with SC28.18.2 (unless due to any act or omission of the Commissioner), the Commissioner may (subject to SC28.21) withhold, a reasonable and proportionate sum of up to 1% of the Expected Monthly Value or of the Actual Monthly Value, as applicable, in respect of the current month and then for each and every month until the Provider has rectified the relevant Information Breach to the reasonable satisfaction of the Commissioner.
28.20 The Commissioner must continue to withhold any sums withheld under SC28.19 unless and until the Provider rectifies the relevant Information Breach to the reasonable satisfaction of the Commissioner. The Commissioner must then pay the withheld sums to the Provider within 10 Operational Days. Subject to SC28.21 no interest will be payable by the Commissioner to the Provider on any sum withheld under SC28.19.
28.21 If the Provider produces evidence satisfactory to the Commissioner that any sums withheld under SC28.19 were withheld without justification, the Commissioner must pay to the Provider any sums wrongly withheld or retained and interest on those sums for the period for which those sums were withheld or retained. If the Commissioner disputes the Provider’s evidence the Provider may refer the matter to Dispute Resolution.
28.22 Any sums withheld under SC28.19 may be retained permanently if the Provider fails to rectify the relevant Information Breach to the reasonable satisfaction of the Commissioner by the earliest of: 28.22.1 the date 3 months after the date of the notice served in accordance with SC28.18; 28.22.2 the termination of this Agreement; and 28.22.3 the Expiry Date.
28.23 The aggregate of sums withheld in any month in respect of Information Breaches is not to exceed 5% of the Expected Monthly Value or of the Actual Monthly Value, as applicable.
Data Quality Improvement Plan 28.24 The Commissioner and the Provider may at any time agree a Data Quality Improvement Plan (which must be appended to this Contract at Schedule 6B (Data Quality Improvement Plans)). Any Data Quality Improvement Plan must set out milestones to be met.
28.25 If an Information Breach relates to the National Requirements Reported Centrally the Parties must not by means of a Data Quality Improvement Plan agree the waiver or delay or foregoing of any withholding or retention under SC28.19 to which the Commissioner would otherwise be entitled.
MANAGING ACTIVITY AND REFERRALS
SC29 Managing Activity and Referrals 29.1 The Commissioner and the Provider must each monitor and manage Activity and Referrals for the Services in accordance with this SC29 and the NHS Payment Scheme.
29.2 The Parties must not agree or implement any action that would operate contrary to the NHS Choice Framework or so as to restrict or impede the exercise by Service Users or others of their legal rights to choice.
29.3 Subject to SC29.3A, the Commissioner must use all reasonable endeavours to: 29.3.1 procure that all Referrers adhere to Referral processes and clinical thresholds set out or referred to in this Contract and/or as otherwise agreed between the Parties and/or as specified in any Prior Approval Scheme; 29.3.2 manage Referral levels in accordance with any Activity Planning Assumptions; and 29.3.3 notify the Provider promptly of any anticipated changes in Referral numbers.
29.3A Not Used.
29.4 The Provider must: 29.4.1 comply with and use all reasonable endeavours to manage Activity in accordance with Referral processes and clinical thresholds set out or referred to in this Contract and/or as otherwise agreed between the Parties and/or as specified in any Prior Approval Scheme, and in accordance with any Activity Planning Assumptions; and 29.4.2 comply with the reasonable requests of the Commissioner to assist the Commissioner in understanding and managing patterns of Referrals.
Indicative Activity Plan 29.5 The Parties may agree an Indicative Activity Plan for each Contract Year, either before the date of this Contract or (failing that) before the start of the relevant Contract Year, specifying the threshold for each activity (and those agreed thresholds may be zero). If the Parties have not agreed an Indicative Activity Plan before the start of any Contract Year an Indicative Activity Plan with an indicative activity of zero will be deemed to apply for that Contract Year.
29.6 The Indicative Activity Plan will comprise the aggregated Indicative Activity Plans of the Commissioner.
Activity Planning Assumptions 29.7 The Commissioner must notify the Provider of any Activity Planning Assumptions for each Contract Year, specifying a threshold for each assumption, either before the date of this Contract or (failing that) before the start of the relevant Contract Year.
Early Warning 29.8 The Commissioner must notify the Provider within 3 Operational Days after becoming aware of any unexpected or unusual patterns of Referrals and/or Activity in relation to any Commissioner, specifying the nature of the unexpected pattern and the Commissioner’s initial opinion as to its likely cause.
29.9 The Provider must notify the Commissioner and the relevant Commissioner within 3 Operational Days after becoming aware of any unexpected or unusual patterns of Referrals and/or Activity in relation to any Commissioner, specifying the nature of the unexpected pattern and the Provider’s initial opinion as to its likely cause.
Reporting and Monitoring Activity 29.10 The Provider must submit an Activity and Finance Report to the Commissioner in accordance with Schedule 6A (Reporting Requirements).
29.11 The Commissioner and the Provider will monitor actual Activity reported in each Activity and Finance Report in respect of each Commissioner against: 29.11.1 thresholds set out in any Indicative Activity Plan; and 29.11.2 thresholds set out in any Activity Planning Assumptions; and 29.11.3 any previous Activity and Finance Reports, as appropriate.
Activity Management Meeting 29.12 Following: 29.12.1 notification by the Commissioner of any unexpected or unusual patterns of Referrals and/or of Activity in accordance with SC29.8; or 29.12.2 notification by the Provider of any unexpected or unusual patterns of Referrals and/or of Activity in accordance with SC29.9; or 29.12.3 the submission of any Activity and Finance Report in accordance with SC29.10 indicating variances against the thresholds set out in any Indicative Activity Plan and/or any breaches of the thresholds set out in any Activity Planning Assumptions and/or any unexpected or unusual patterns of Referrals and/or Activity (as appropriate), in relation to any Commissioner, either the Commissioner or the Provider may issue to the other an Activity Query Notice.
29.13 The Commissioner and the Provider must meet to discuss any Activity Query Notice within 10 Operational Days following its issue.
29.14 At that meeting the Commissioner and the Provider must: 29.14.1 consider patterns of Referrals, of Activity and of the exercise by Service Users of their legal rights to choice; and 29.14.2 agree either: 29.14.2.1 that the Activity Query Notice is withdrawn; or 29.14.2.2 to hold a meeting to discuss Utilisation, in which case the provisions of SC29.15 will apply; or 29.14.2.3 to conduct a Joint Activity Review, in which case the provisions of SC29.16 to 29.20 will apply.
Utilisation Review Meeting 29.15 Within 10 Operational Days following agreement to hold a meeting under SC29.14, the Commissioner and the Provider must meet: 29.15.1 to agree a plan to improve Utilisation and/or update any previously agreed plan; and 29.15.2 to discuss any matter that either considers necessary in relation to Utilisation.
Joint Activity Review 29.16 Within 10 Operational Days following agreement to conduct a Joint Activity Review under SC29.14, the Commissioner and the Provider must meet: 29.16.1 to consider in further detail the matters referred to in SC29.14.1 and the causes of the unexpected or unusual pattern of Referrals and/or Activity; and 29.16.2 (if they consider it necessary or appropriate) to agree an Activity Management Plan.
29.17 The Commissioner and the Provider should not agree an Activity Management Plan in respect of any unexpected or unusual pattern of Referrals and/or Activity which they agree was caused wholly or mainly by the exercise by Service Users of their rights to choice.
29.18 If the Commissioner and the Provider fail to agree an Activity Management Plan at or within 10 Operational Days following the Joint Activity Review they must issue a joint notice to that effect to the Governing Body of the Provider and of each Commissioner. If the Commissioner and the Provider have still not agreed an Activity Management Plan within 10 Operational Days following the date of the joint notice, either may refer the matter to Dispute Resolution.
29.19 The Parties must implement any Activity Management Plan agreed or determined in accordance with SC29.16 to 29.18 inclusive in accordance with its terms.
29.20 If any Party breaches the terms of an Activity Management Plan, the Commissioner or the Provider (as appropriate) may exercise any consequences set out in it.
Prior Approval Scheme 29.21 Before the start of each Contract Year, the Commissioner must notify the Provider of the terms of any Prior Approval Scheme for that Contract Year. In determining whether to implement any new or replacement Prior Approval Scheme or to amend any existing Prior Approval Scheme, the Commissioner must have regard to the burden which Prior Approval Schemes may place on the Provider. The Commissioner must use reasonable endeavours to minimise the number of separate Commissioner-specific Prior Approval Schemes in relation to any individual condition or treatment. The terms of any Prior Approval Scheme may specify the information which the Provider must submit to the Commissioner about individual Service Users requiring or receiving treatment under that Prior Approval Scheme, including details of the scope of the information to be submitted and the format, timescale and process for submission (which may be paper-based or via specified electronic systems).
29.22 The Provider must manage Referrals in accordance with the terms of any Prior Approval Scheme. If the Provider does not comply with the terms of any Prior Approval Scheme in providing a Service to a Service User, the Commissioner will not be liable to pay for the Service provided to that Service User.
29.23 If a Prior Approval Scheme imposes any obligation on a Provider that would operate contrary to the NHS Choice Framework: 29.23.1 that obligation will have no contractual force or effect; and 29.23.2 the Prior Approval Scheme must be amended accordingly; and 29.23.3 if the Provider provides any Service in accordance with the Prior Approval Scheme as amended in accordance with SC29.23.2 the relevant Commissioner will be liable to pay for that Service in accordance with SC36 (Payment Terms).
29.24 The Commissioner may at any time during a Contract Year give the Provider not less than one month’s notice in writing of any new or replacement Prior Approval Scheme, or of any amendment to an existing Prior Approval Scheme. That new, replacement or amended Prior Approval Scheme must be implemented by the Provider on the date set out in the notice, and will only be applicable to decisions to offer treatment made after that date.
29.25 Subject to the timely provision by the Provider of all of the information specified within a Prior Approval Scheme, the relevant Commissioner must respond within the Prior Approval Response Time Standard to any request for approval for treatment for an individual Service User. If the Commissioner fails to do so, it will be deemed to have given Prior Approval.
29.26 Each Commissioner and the Provider must use all reasonable endeavours to ensure that the design and operation of Prior Approval Schemes does not cause undue delay in Service Users accessing clinically appropriate treatment and does not place at risk achievement by the Provider of any Quality Requirement.
29.27 At the Provider’s request in case of urgent clinical need or a risk to patient safety, and if approved by the Commissioner’s medical director or clinical chair (that approval not be unreasonably withheld or delayed), the relevant Commissioner must grant retrospective Prior Approval for a Service provided to a Service User.
Evidence-Based Interventions Guidance 29.28 The Commissioner must use all reasonable endeavours to procure that, when making Referrals, Referrers comply with the Evidence-Based Interventions Guidance.
29.29 The Provider must manage Referrals and provide the Services in accordance with the Evidence-Based Interventions Guidance.
EMERGENCIES AND INCIDENTS
SC30 Emergency Preparedness, Resilience and Response 30.1 The Provider must comply with EPRR Guidance if and when applicable. The Provider must identify and have in place an Accountable Emergency Officer.
30.2 The Provider must notify the Commissioner as soon as reasonably practicable and in any event no later than 5 Operational Days following: 30.2.1 the activation of its Incident Response Plan; 30.2.2 any risk, or any actual disruption, to CRS or Essential Services; and/or 30.2.3 the activation of its Business Continuity Plan.
30.3 The Commissioner must have in place arrangements that enable the receipt at all times of a notification made under SC30.2.
30.4 The Provider must provide whatever support and assistance may reasonably be required by the Commissioner and/or NHS England and/or the UK Health Security Agency in response to any national, regional or local public health emergency or incident.
30.5 The right the Commissioner to: 30.5.1 withhold or retain sums under GC9 (Contract Management); and/or 30.5.2 suspend Services under GC16 (Suspension), will not apply if the relevant right to withhold, retain or suspend has arisen only as a result of the Provider complying with its obligations under this SC30.
30.6 The Provider must use reasonable endeavours to minimise the effect of an Incident or Emergency on the Services and to continue the provision of Elective Care and Non-elective Care notwithstanding the Incident or Emergency. If a Service User is already receiving treatment when the Incident or Emergency occurs, or is admitted after the date it occurs, the Provider must not: 30.6.1 discharge the Service User, unless clinically appropriate to do so in accordance with Good Practice; or 30.6.2 transfer the Service User, unless it is clinically appropriate to do so in accordance with Good Practice.
30.7 Subject to SC30.6, if the impact of an Incident or Emergency is that the demand for Non-elective Care increases, and the Provider establishes to the satisfaction of the Commissioner that its ability to provide Elective Care is reduced as a result, Elective Care will be suspended or scaled back as necessary for as long as the Provider’s ability to provide it is reduced. The Provider must give the Commissioner written confirmation every 2 calendar days of the continuing impact of the Incident or Emergency on its ability to provide Elective Care.
30.8 During or in relation to any suspension or scaling back of Elective Care in accordance with SC30.7: 30.8.1 GC16 (Suspension) will not apply to that suspension; 30.8.2 if requested by the Provider, the Commissioner must use their reasonable efforts to avoid any new referrals for Elective Care and the Provider may if necessary change its waiting lists for Elective Care; and 30.8.3 the Provider must continue to provide Non-elective Care (and any related Elective Care), subject to the Provider’s discretion to transfer or divert a Service User if the Provider considers that to be in the best interests of all Service Users to whom the Provider is providing Non- elective Care whether or not as a result of the Incident or Emergency (using that discretion in accordance with Good Practice).
30.9 If, despite the Provider complying fully with its obligations under this SC30, there are transfers, postponements and cancellations the Provider must give the Commissioner notice of:
30.9.1 the identity of each Service User who has been transferred and the alternative provider; 30.9.2 the identity of each Service User who has not been but is likely to be transferred, the probable date of transfer and the identity of the intended alternative provider; 30.9.3 cancellations and postponements of admission dates; 30.9.4 cancellations and postponements of out-patient appointments; and 30.9.5 other changes in the Provider’s list.
30.10 As soon as reasonably practicable after the Provider gives written notice to the Commissioner that the effects of the Incident or Emergency have ceased, the Provider must fully restore the availability of Elective Care.
SC31 Force Majeure: Service-specific provisions 31.1 Nothing in this Contract will relieve the Provider from its obligations to provide the Services in accordance with this Contract and the Law (including the Civil Contingencies Act 2004) if the Services required relate to an unforeseen event or circumstance including war, civil war, armed conflict or terrorism, strikes or lock outs, riot, fire, flood or earthquake.
31.2 This will not however prevent the Provider from relying upon GC28 (Force Majeure) if such event described in SC31.1 is itself an Event of Force Majeure or if the subsequent occurrence of a separate Event of Force Majeure prevents the Provider from delivering those Services.
31.3 Not Used
31.4 Not Used
SAFETY AND SAFEGUARDING
SC32 Safeguarding Children and Adults 32.1 The Provider must ensure that Service Users are protected from abuse, exploitation, radicalisation, serious violence, grooming, neglect and improper or degrading treatment, and must take appropriate action to respond to any allegation or disclosure of any such behaviours in accordance with the Law.
32.2 The Provider must nominate: 32.2.1 Safeguarding Leads and/or named professionals for safeguarding children (including looked after children) and for safeguarding adults, in accordance with Safeguarding Guidance; 32.2.2 a Child Sexual Abuse and Exploitation Lead; 32.2.3 a Mental Capacity and Liberty Protection Safeguards Lead; and 32.2.4 a Prevent Lead, and must ensure that the Commissioner is kept informed at all times of the identity of the persons holding those positions.
32.3 The Provider must comply with the requirements and principles in relation to the safeguarding of children, young people and adults, including in relation to deprivation of liberty safeguards, child sexual abuse and exploitation, domestic abuse, radicalisation and female genital mutilation (as relevant to the Services) set out or referred to in: 32.3.1 the 2014 Act and associated Guidance; 32.3.2 the 2014 Regulations; 32.3.3 the Children Act 1989 and the Children Act 2004 and associated Guidance; 32.3.4 the 2005 Act and associated Guidance; 32.3.5 the Modern Slavery Act 2015 and associated Guidance; 32.3.6 Safeguarding Guidance; 32.3.7 Child Sexual Abuse and Exploitation Guidance; 32.3.8 Prevent Guidance; and 32.3.9 the Domestic Abuse Act 2021 and associated Guidance.
32.4 The Provider has adopted and must comply with the Safeguarding Policies and MCA Policies. The Provider has ensured and must at all times ensure that the Safeguarding Policies and MCA Policies reflect and comply with: 32.4.1 the Law and Guidance referred to in SC32.3; and 32.4.2 the local multi-agency policies and any Commissioner safeguarding and MCA requirements.
32.5 The Provider must implement comprehensive programmes for safeguarding (including in relation to child sexual abuse and exploitation) and MCA training for all relevant Staff and must have regard to Intercollegiate Guidance in Relation to Safeguarding Training. The Provider must undertake an annual audit of its conduct and completion of those training programmes and of its compliance with the requirements of SC32.1 to 32.4.
32.6 At the reasonable written request of the Commissioner, and by no later than 10 Operational Days following receipt of that request, the Provider must provide evidence to the Commissioner that it is addressing any safeguarding concerns raised through the relevant multi-agency reporting systems.
32.7 If requested by the Commissioner, the Provider must participate in the development of any local multi-agency safeguarding quality indicators and/or plan.
32.8 The Provider must co-operate fully and liaise appropriately with third party providers of social care services as necessary for the effective operation of the Child Protection Information Sharing Project.
32.9 The Provider must: 32.9.1 include in its policies and procedures, and comply with, the principles contained in the Government Prevent Strategy and the Prevent Guidance; and 32.9.2 include in relevant policies and procedures a comprehensive programme to raise awareness of the Government Prevent Strategy among Staff and volunteers in line with the NHS England Prevent Training and Competencies Framework and Intercollegiate Guidance in Relation to Safeguarding Training.
SC33 Patient Safety 33.1 The Provider must comply with the arrangements for notification of deaths and other incidents: 33.1.1 to CQC, in accordance with CQC Regulations and Guidance (where applicable); and 33.1.2 to any other relevant Regulatory or Supervisory Body, any NHS Body, any office or agency of the Crown, or to any other appropriate regulatory or official body, in accordance with Good Practice and the Law; and 33.1.3 in the case of any Service User with a learning disability and/or autism whose death occurs while an inpatient in any Service or of whose death the Provider otherwise becomes aware, report that death via the Learning from Lives and Deaths Platform.
33.2 Until the PSIRF Implementation Date, the Provider must comply with the NHS Serious Incident Framework and the Never Events Policy Framework, as applicable. With effect from the PSIRF Implementation Date, the Provider must comply with the Patient Safety Incident Response Framework and the Never Events Policy Framework.
33.3 Before the PSIRF Implementation Date, the Provider must agree with the Co- ordinating Commissioner a Patient Safety Incident Response Policy and a Patient Safety Incident Response Plan, in each case in accordance with the Patient Safety Incident Response Framework. With effect from the PSIRF Implementation Date, the Provider must: 33.3.1 publish on its website the agreed Patient Safety Incident Response Policy and Patient Safety Incident Response Plan; 33.3.2 engage compassionately with affected Service Users, Carers and Staff following any Patient Safety Incident; 33.3.3 respond in a proportionate way to Patient Safety Incidents, undertaking Patient Safety Incident Investigations where appropriate; and 33.3.4 ensure that, where indicated and as part of the overall process set out in SC3.4, improvements to the Services are implemented following responses to Patient Safety Incidents, in accordance with the Patient Safety Incident Response Framework.
33.4 The Provider must ensure that it is able to report Patient Safety Incidents to the National Reporting and Learning System and to any system which replaces it.
33.5 The Parties must comply with their respective obligations in relation to deaths and other incidents in connection with the Services under Schedule 6A (Reporting Requirements).
33.6 If a notification the Provider gives to any relevant Regulatory or Supervisory Body directly or indirectly concerns any Service User, the Provider must send a copy of it to the relevant Commissioner.
33.7 The Commissioner will have complete discretion (subject only to the Law) to use the information provided by the Provider under this SC33 and Schedule 6A (Reporting Requirements) in any report which they make to any relevant Regulatory or Supervisory Body, any NHS Body, any office or agency of the Crown, provided that in each case they notify the Provider of the information disclosed and the body to which they have disclosed it.
33.8 The Provider must have in place arrangements to ensure that it can: 33.8.1 receive National Patient Safety Alerts; and
33.8.2 in relation to each National Patient Safety Alert it receives, identify appropriate Staff: 33.8.2.1 to coordinate and implement any actions required by the alert within the timescale prescribed; and 33.8.2.2 to confirm and record when those actions have been completed.
33.9 The Provider must 33.9.1 designate one or more Patient Safety Specialists; and 33.9.2 ensure that the Commissioner is kept informed at all times of the person or persons holding this position.
33.10 The Provider must: 33.10.1 appoint a Medical Devices Safety Officer and a Medication Safety Officer; and 33.10.2 ensure that the Commissioner and the MHRA Central Alerting System are kept informed at all times of the person or persons holding these positions.
SC34 End of Life Care 34.1 The Provider must have regard to Guidance on End of Life Care and must, where applicable and for as long as it remains operative, comply with SCCI 1580 (Palliative Care Co-ordination: Core Content).
34.2 The Provider must maintain and operate a Death of a Service User Policy.
SC35 Duty of Candour 35.1 The Provider must act in an open and transparent way with Relevant Persons in relation to Services provided to Service Users.
35.2 The Provider must, where applicable, comply with its obligations under regulation 20 of the 2014 Regulations in respect of any Notifiable Safety Incident.
35.3 If the Provider fails to comply with any of its obligations under SC35.2 the Co- ordinating Commissioner may: 35.3.1 notify the CQC of that failure; and/or
35.3.2 require the Provider to provide the Relevant Person with a formal, written apology and explanation for that failure, signed by the Provider’s chief executive and copied to the relevant Commissioner; and/or 35.3.3 require the Provider to publish details of that failure prominently on the Provider’s website.
PAYMENT TERMS
SC36 Payment Terms Payment Principles 36.1 Subject to any express provision of this Contract to the contrary, the Commissioner must pay the Provider in accordance with the NHS Payment Scheme, to the extent applicable, for all Services that the Provider delivers to it in accordance with this Contract. All
36.2 To avoid any doubt, the Provider will be entitled to be paid for Services delivered during the continuation of: 36.2.1 any Incident or Emergency, except as otherwise provided or agreed under SC30 (Emergency Preparedness, Resilience and Response); and 36.2.2 any Event of Force Majeure, except as otherwise provided or agreed under GC28 (Force Majeure). All
Prices 36.3 If the Provider is an NHS Trust or an NHS Foundation Trust, the Prices payable by the Commissioner for Services delivered under this Contract for the relevant Contract Year will be: 36.3.1 the price(s) payable in accordance with rule 2 of the Aligned Payment and Incentive Rules; or 36.3.2 the price(s) payable in accordance with rule 2 of the Aligned Payment and Incentive Rules, adjusted for the relevant Contract Year as agreed, approved by NHS England and published in accordance with rule 3 of the Aligned Payment and Incentive Rules, in either case recorded in Schedule 3A (Aligned Payment and Incentive Rules) and, where applicable, Schedule 3C (Local Prices); and/or All
36.3.3 where rule 4 or rule 5a)ii of the Aligned Payment and Incentive Rules applies, the price(s) agreed or determined in accordance with that rule and recorded in Schedule 3C (Local Prices), for the relevant Contract Year.
36.4 If the Provider is not an NHS Trust or an NHS Foundation Trust, the Prices payable by each Commissioner for Services delivered under this Contract for the relevant Contract Year will be: 36.4.1 for any Service for which the NHS Payment Scheme mandates an NHSPS Unit Price: 36.4.1.1 the NHSPS Unit Price; or 36.4.1.2 the NHSPS Unit Price as adjusted by a Locally Agreed Adjustment for the relevant Contact Year, submitted to NHS England, published and recorded in Schedule 3B (Locally Agreed Adjustments to NHS Payment Scheme Unit Prices), in accordance with rule 3 of section 6 of the NHS Payment Scheme; or 36.4.2 for any Service for which the NHS Payment Scheme does not mandate an NHSPS Unit Price, the Local Price agreed or determined for the relevant Contract Year in accordance with the rules set out in section 7 of the NHS Payment Scheme and recorded in Schedule 3C (Local Prices).
36.5 Where the rule set out in section 3.4 of the NHS Payment Scheme applies, the price payable by each Commissioner for any high cost drug, device, listed product or listed innovative product listed in Annex A to the NHS Pricing Scheme to which that rule applies will be the price as agreed or determined (and subject to any adjustment which must be made) in accordance with that rule, and where necessary recorded in Schedule 3C (Local Prices).
Local Prices 36.6 For any Service in respect of which none of the payment mechanisms set out in sections 4 – 6 of the NHS Payment Scheme determines a price, the Commissioner and the Provider must agree and record in Schedule 3C (Local Prices) a Local Price. The Commissioner and the Provider may agree that a Local Price is to apply for one or more Contract Years or for the duration of the Contract. In respect of a Local Price agreed for more than one Contract Year the Commissioner and the Provider may agree and document in Schedule 3C (Local Prices) the mechanism by which that Local Price is to be adjusted with effect from the start of each Contract Year. Any adjustment mechanism must require the Commissioner and the Provider to have regard to the efficiency factor and cost uplift factor set out in the NHS Payment Scheme where applicable.
36.7 The Commissioner and the Provider must apply annually any adjustment mechanism agreed and documented in Schedule 3C (Local Prices). Where no adjustment mechanism has been agreed, the Commissioner and the Provider must review and agree before the start of each Contract Year the Local Price to apply to the following Contract Year, having regard to the efficiency factor and the cost uplift factor set out in the NHS Payment Scheme where applicable. In either case the Local Price as adjusted or agreed will apply to the following Contract Year.
36.8 If the Commissioner and the Provider fail to review or agree any Local Price for the following Contract Year by the date 2 months before the start of that Contract Year, or there is a dispute as to the application of any agreed adjustment mechanism, either may refer the matter to Dispute Resolution for escalated negotiation and then (failing agreement) mediation.
36.9 If on or following completion of the mediation process the Commissioner and the Provider still cannot agree any Local Price for the following Contract Year, within 10 Operational Days of completion of the mediation process either the Commissioner or the Provider may terminate the affected Services by giving the other not less than 6 months’ written notice.
36.10 If any Local Price has not been agreed or determined in accordance with SC36.7 and 36.8 before the start of a Contract Year, then the Local Price will be that which applied for the previous Contract Year increased or decreased in accordance with the efficiency factor and the cost uplift factor set out in the NHS Payment Scheme where applicable. The application of these prices will not affect the right to terminate this Contract as a result of non-agreement of a Local Prices under SC36.9.
Aggregation and Disaggregation of Payments 36.11 Not Used
Payment where the Parties have agreed an Expected Annual Contract Value 36.12 If the Provider is an NHS Trust or an NHS Foundation Trust, the Commissioner must agree an Expected Annual Contract Value with the Provider to be specified in Schedule 3D (Expected Annual Contract Values). If the Provider is not an NHS Trust or an NHS Foundation Trust, the Commissioner may agree an Expected Annual Contract Value with the Provider to be specified in Schedule 3D (Expected Annual Contract Values). The Commissioner must make payments on account to the Provider in accordance with the following provisions of SC36.13, or if applicable SC36.14 and 36.15.
36.13 The Provider must supply to the Commissioner a monthly invoice on the first day of each month setting out the amount to be paid by the Commissioner for that month. The amount to be paid will be one twelfth (or other such proportion as may be specified in Schedule 3D (Expected Annual Contract Values)) of the individual Expected Annual Contract Value for the Commissioner. Subject to receipt of the invoice, on the fifteenth day of each month (or other day agreed by the Provider and the Commissioner in writing) after the Service Commencement Date each Commissioner must pay such amount to the Provider.
36.14 If the Service Commencement Date is not 1 April the timing and amounts of the payments for the period starting on the Service Commencement Date and ending on the following 31 March will be as set out in Schedule 3E (Timing and Amounts of Payments in First and/or Final Contract Year).
36.15 If the Expiry Date is not 31 March the timing and amounts of the payments for the period starting on the 1 April prior to the Expiry Date and ending on the Expiry Date will be as set out in Schedule 3E (Timing and Amounts of Payments in First and/or Final Contract Year).
Reconciliation where the Parties have agreed an Expected Annual Contract Value and SUS applies to some or all of the Services 36.16 Where the Parties have agreed an Expected Annual Contract Value and SUS applies to some or all of the Services, in order to confirm the actual sums payable for the Services delivered the Provider must provide a separate reconciliation account for each Commissioner for each Quarter showing the sum equal to the Prices for all relevant Services delivered and completed in that Quarter. That reconciliation account must be based on the information submitted by the Provider to the Commissioner under SC28 (Information Requirements) and must be sent by the Provider to the relevant Commissioner by the First Quarterly Reconciliation Date for the Quarter to which it relates.
36.17 The Provider must send to the Commissioner a final reconciliation account for each Quarter within 5 Operational Days after the Final Quarterly Reconciliation Date for that Quarter. The final reconciliation account must either be agreed by the Commissioner, or be wholly or partially contested by the
Commissioner in accordance with SC36.31. The Commissioner may not unreasonably withhold or delay its agreement to a final reconciliation account.
Reconciliation for Services where the Parties have agreed an Expected Annual Contract Value and SUS does not apply to any of the Services 36.18 Where the Parties have agreed an Expected Annual Contract Value and SUS does not apply to any of the Services, in order to confirm the actual sums payable for delivered Services the Provider must provide a separate reconciliation account for each Commissioner for each Quarter showing the sum equal to the Prices for all relevant Services delivered and completed in that Quarter. That reconciliation account must be based on the information submitted by the Provider to the Commissioner under SC28 (Information Requirements) and sent by the Provider to the relevant Commissioner within 20 Operational Days after the end of the Quarter to which it relates.
36.19 The Commissioner and Provider must either agree the reconciliation account produced in accordance with SC36.18 or wholly or partially contest the reconciliation account in accordance with SC36.31. The Commissioner may not unreasonably withhold or delay its agreement to a reconciliation account.
Other aspects of reconciliation for all Prices where the Parties have agreed an Expected Annual Value 36.20 For the avoidance of doubt, there will be no reconciliation in relation to Block Arrangements.
36.21 T h e Commissioner’s agreement of a reconciliation account or agreement of a final reconciliation account as the case may be (or where agreed in part in relation to that part) will trigger a reconciliation payment by the Commissioner to the Provider or by the Provider to the Commissioner, as appropriate. The Provider must supply to the Commissioner an invoice or credit note (as appropriate) within 5 Operational Days of that agreement and payment must be made within 10 Operational Days following the receipt of the invoice or issue of the credit note (or if SUS applies, and if later, within 10 Operational Days after the relevant First Monthly Reconciliation Date or First Quarterly Reconciliation Date).
Payment where the Parties have not agreed an Expected Annual Contract Value for any Services and SUS applies to some or all of the Services 36.22 Where the Parties have not agreed an Expected Annual Contract Value and SUS applies to some or all of the Services, the Provider (if it is not an NHS Trust or a Foundation Trust) must issue a monthly invoice within 5 Operational Days after the Final Monthly Reconciliation Date for that month to the Commissioner in respect of those Services provided for the Commissioner in that month. Subject to SC36.31, the Commissioner must settle the invoice within 10 Operational Days of its receipt (or, if later, within 10 Operational Days after the relevant First Monthly Reconciliation Date).
Payment where the Parties have not agreed an Expected Annual Contract Value for any Services and SUS does not apply to any of the Services 36.23 Where SUS does not apply to any of the Provider’s Services and where the Parties have not agreed an Expected Annual Contract Value, the Provider (if it is not an NHS Trust or a Foundation Trust) must issue a monthly invoice within 20 Operational Days after the end of each month to the Commissioner in respect of all Services provided for the Commissioner in that month. Subject to SC36.31, the Commissioner must settle the invoice within 10 Operational Days of its receipt.
Statutory and Other Charges 36.24 Where applicable, the Provider must administer all statutory benefits to which the Service User is entitled and within a maximum of 20 Operational Days following receipt of an appropriate invoice the Commissioner must reimburse the Provider any statutory benefits correctly administered.
36.25 The Provider must administer and collect all statutory charges which the Service User is liable to pay and which may lawfully be made in relation to the provision of the Services, and must account to whoever the Commissioner reasonably directs in respect of those charges.
36.26 The Parties acknowledge the requirements and intent of the Overseas Visitor Charging Regulations and Overseas Visitor Charging Guidance, and accordingly: 36.26.1 the Provider must comply with all applicable Law and Guidance (including the Overseas Visitor Charging Regulations and the Overseas Visitor Charging Guidance) in relation to the identification of and collection of charges from Chargeable Overseas Visitors, including the reporting of unpaid NHS debts in respect of Services provided to Chargeable Overseas Visitors to the Department of Health and Social Care; 36.26.2 the Provider must take all reasonable steps to: 36.26.2.1 identify each Chargeable Overseas Visitor; and 36.26.2.2 recover charges from each Chargeable Overseas Visitor or other person liable to pay charges in respect of that Chargeable Overseas Visitor under the Overseas Visitor Charging Regulations, 36.26.3 the Provider must make full use of existing mechanisms designed to increase the rates of recovery of the cost of Services provided to overseas visitors insured by another state, including the overseas visitors treatment portal; and 36.26.4 the Commissioner must pay the Provider, in accordance with all applicable Law and Guidance (including Overseas Visitor Charging Regulations and Overseas Visitor Charging Guidance) and the NHS Payment Scheme, the appropriate sum for all Services delivered by the
Provider to any overseas visitor in respect of whom the Commissioner is the Commissioner and which have been reported through the overseas visitor treatment portal.
36.27 In its performance of this Contract the Provider must not provide or offer to a Service User any clinical or medical services for which any charges would be payable by the Service User except in accordance with this Contract, the Law and/or Guidance.
Patient Pocket Money 36.28 Not Used
VAT 36.29 Payment is exclusive of any applicable VAT for which the Commissioner will be additionally liable to pay the Provider upon receipt of a valid tax invoice at the prevailing rate in force from time to time.
Contested Payments 36.30 Once the Provider has submitted Activity data to SUS in respect of a given month, the Commissioner may raise with the Provider any validation queries it has in relation to that data, and the Provider must answer those queries promptly and fully. The Parties must use all reasonable endeavours to resolve any queries by the Post Reconciliation Monthly Inclusion Date.
36.31 If a Commissioner contests all or any part of any payment calculated in accordance with this SC36: 36.31.1 the Commissioner must: 36.31.1.1 within 5 Operational Days after receiving the reconciliation account in accordance with SC36.16 or an invoice in accordance with SC36.23; or 36.31.1.2 within 5 Operational Days after receiving the final reconciliation account in accordance with SC36.17 (or, if later, within 5 Operational Days after the relevant First Quarterly Reconciliation Date); or 36.31.1.3 within 5 Operational Days after receiving an invoice in accordance with SC36.22 (or, if later, within 5 Operational Days after the relevant First Monthly Reconciliation Date),
as appropriate, notify the Provider, setting out in reasonable detail the reasons for contesting that account or invoice (as applicable), and in particular identifying which elements are contested and which are not contested; and 36.31.2 any uncontested amount must be paid in accordance with this Contract by the Commissioner; and 36.31.3 if the matter has not been resolved within 20 Operational Days of the date of notification under SC36.31.1, the Commissioner must refer the matter to Dispute Resolution, and following the resolution of any Dispute referred to Dispute Resolution in accordance with this SC36.31, insofar as any amount shall be agreed or determined to be payable the Provider must immediately issue an invoice or credit note (as appropriate) for such amount. Any sum due must be paid immediately together with interest calculated in accordance with SC36.32. For the purposes of SC36.32 the date the amount was due will be the date it would have been due had the amount not been disputed.
Interest on Late Payments 36.32 Subject to any express provision of this Contract to the contrary (including without limitation the Withholding and Retention of Payment Provisions), each Party will be entitled, in addition to any other right or remedy, to receive interest at the applicable rate under the Late Payment of Commercial Debts (Interest) Act 1998 on any payment not made from the date after the date on which payment was due up to and including the date of payment.
Set Off 36.33 Whenever any sum is due from one Party to another as a consequence of reconciliation under this SC36 or Dispute Resolution or otherwise, the Party due to be paid that sum may deduct it from any amount that it is due to pay the other, provided that it has given 5 Operational Days’ notice of its intention to do so.
Invoice Validation 36.34 The Parties must comply with Law and Guidance (including Who Pays? Guidance and Invoice Validation Guidance) in respect of the use of data in the preparation and validation of invoices.
Submission of Invoices 36.35 The Provider must submit all invoices via the e-Invoicing Platform in accordance with e-Invoicing Guidance or via an alternative PEPPOL-compliant e-invoicing system.
QUALITY REQUIREMENTS
SC37 Local Quality Requirements 37.1 The Parties must comply with their duties under the Law to improve the quality of clinical and/or care services for Service Users, having regard to Guidance.
37.2 Nothing in this Contract is intended to prevent this Contract from setting higher quality requirements than those laid down under the Provider Licence (if any) or required by any relevant Regulatory or Supervisory Body.
37.3 Before the start of each Contract Year, the Commissioner and the Provider will agree the Local Quality Requirements that are to apply in respect of that Contract Year. In order to secure continual improvement in the quality of the Services, those Local Quality Requirements must not, except in exceptional circumstances, be lower or less onerous than those for the previous Contract Year. The Commissioner and the Provider must give effect to those revised Local Quality Requirements by means of a Variation (and, where revised Local Quality Requirements are in respect of a Service to which an NHSPS Unit Price applies and if appropriate, a Locally Agreed Adjustment in accordance with SC36.4.1.2).
37.4 If revised Local Quality Requirements cannot be agreed between the Parties, the Parties must refer the matter to Dispute Resolution for escalated negotiation and then (failing agreement) mediation.
SC38 CQUIN 38.1 Not Used
CQUIN Performance Report 38.2 Not Used.
38.3 Not Used
38.4 Not Used
38.5 Not Used
38.6 Not Used
Reconciliation 38.7 Not Used
38.8 Not Used
38.9 Not Used
38.10 Not Used
PROCUREMENT OF GOODS AND SERVICES
SC39 Procurement of Goods and Services 39.1 The provisions of SC39.2 – 39.7 below apply to NHS Trusts and to NHS Foundation Trusts only.
39.2 If an NHSE Medicines Framework Product is clinically appropriate for use in relation to the Services and is at the time of purchase available via an NHSE Medicines Framework Agreement, the Provider must purchase that product via the relevant NHSE Medicines Framework Agreement. This does not preclude the use of the Provider’s existing stock of the same or a similar product purchased through other means before 1 April 2023 or, if later, the date on which the relevant NHSE Medicines Framework Agreement came into effect.
39.3 The Provider will not be entitled to payment for any medicine purchased in breach of SC39.2 where that medicine is listed in the High Cost Drugs tab at Annex A to the NHS Payment Scheme.
39.4 Whether or not SC39.3 applies, the Provider must be prepared, on request, to provide a written statement to the Commissioner, to its public board and/or to NHS England, explaining any purchasing decision in contravention of SC39.2 and what it will do to ensure that SC39.2 is complied with in future.
39.5 If any device which is listed in the High Cost Devices and Listed Procedures tab at Annex A to the NHS Payment Scheme is required in the delivery of any Service which is a Specialised Service and is available for purchase via NHS Supply Chain, the Provider must purchase that device via NHS Supply Chain. The Provider will not be entitled to payment for any such item purchased in breach of this SC39.5.
Nationally Contracted Products Programme 39.6 The Provider must use all reasonable endeavours to co-operate with NHS England and NHS Supply Chain to implement in full the requirements of the Nationally Contracted Products Programme.
National Ambulance Vehicle Specification 39.7 If the Provider wishes to place any order for a new standard double-crewed emergency ambulance base vehicle and/or conversion for use in provision of the Services, it must (unless it has received written confirmation, in advance, from the Commissioner that the Commissioner has agreed in writing with NHS England that the National Ambulance Vehicle Specification need not apply to that order): 39.7.1 ensure that its order specifies that the vehicle and/or conversion must comply with the National Ambulance Vehicle Specification; and 39.7.2 place its order via and in accordance with a Compliant Ambulance Vehicle Supply Contract.
National Genomic Test Directory 39.8 Where, in the course of providing the Services, the Provider or any Sub-Contractor requires a sample taken from a Service User to be subject to a genomic laboratory test listed in the National Genomic Test Directory, that sample must be submitted to the appropriate Genomic Laboratory Hub commissioned by NHS England to arrange and/or perform the relevant test. Each submission of a sample must be made in accordance with the criteria for ordering tests set out in the National Genomic Test Directory.
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
RTT waiting times for non-
urgent Consultant-led
Services
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 to NHS England) See RTT Rules Suite and Recording and Reporting FAQs at: https://www.england.nhs.uk/statistics/ statistical-work-areas/rtt-waiting- times/rtt-guidance/ Month A, CS, MH
E.B.S.4 Zero tolerance RTT waits over 78 weeks for incomplete pathways From April 2023 >0 * See RTT Rules Suite and Recording and Reporting FAQs at: https://www.england.nhs.uk/statistics/ statistical-work-areas/rtt-waiting- times/rtt-guidance/ Ongoing A, CS, MH
E.B.S.4 Zero tolerance RTT waits over 65 weeks for incomplete pathways By 31 March 2024 >0 * See RTT Rules Suite and Recording and Reporting FAQs at: https://www.england.nhs.uk/statistics/ statistical-work-areas/rtt-waiting- times/rtt-guidance/ Ongoing A, CS, MH
* subject to any tolerances confirmed in national guidance for Service Users who choose to wait longer or for specific specialties
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% See Diagnostics Definitions and Diagnostics FAQs at: https://www.england.nhs.uk/statistics/ statistical-work-areas/diagnostics- waiting-times-and-activity/monthly- diagnostics-waiting-times-and- activity/ Month A, CS, CR, D
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
A+E waits
Cancer waits - 2 week wait
E.B.6 Percentage of Service Users referred urgently with suspected cancer by a GP waiting no more than two weeks for first outpatient appointment Operating standard of 93% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter A, CR, R
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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter A, CR, R
Cancer waits – 28 / 31 days
E.B.27 Percentage of Service Users waiting no more than 28 days from urgent referral to receiving a communication of diagnosis for cancer or a ruling out of cancer Operating standard of 75%, by March 2024 See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter A, CR, R
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter 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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter 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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter 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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter 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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter A, CR, R
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
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% See National Cancer Waiting Times Monitoring Dataset Guidance, available at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancer-waiting- times/ Quarter A, CR, R
Cancer
Full implementation of an effective e-Prescribing system for chemotherapy across all relevant clinical teams within the Provider (other than those dealing with children, teenagers and young adults) across all tumour sites (Specialised Services only, including where NHS England has delegated the function of commissioning those services to an ICB) Failure to achieve full implementation as described under Service Specification B15/S/a Cancer: Chemotherapy (Adult) National Service Specification at: https://www.england.nhs.uk/specialis ed-commissioning-document- library/service-specifications/ Ongoing CR
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 (Specialised Services only, including where NHS England has delegated the function of commissioning those services to an ICB) Failure to achieve full implementation as described under Service Specification B15/S/b Cancer: Chemotherapy (Children, Teenagers and Young Adults) National Service Specification at: https://www.england.nhs.uk/specialis ed-commissioning-document- library/service-specifications/ Ongoing CR
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
Ambulance Service Response
Times
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
Ambulance service handover
times
Mixed-sex accommodation
breaches
E.B.S.1 Mixed-sex accommodation breach >0 See Mixed-Sex Accommodation Guidance, Mixed-Sex Accommodation FAQ and Professional Letter at: https://www.england.nhs.uk/statistics/ statistical-work-areas/mixed-sex- accommodation/ Ongoing A, CR, MH
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
Cancelled operations
E.B.S.2 All Service Users who have operations cancelled, on or after the day of admission (including the day of surgery), for non- clinical 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 Users who are not offered another binding date within 28 days >0 See Cancelled Operations Guidance and Cancelled Operations FAQ at: https://www.england.nhs.uk/statistics/ statistical-work-areas/cancelled- elective-operations/ Ongoing A, CR
E.B.S.6 No urgent operation should be cancelled for a second time >0 See Contract Technical Guidance Appendix 2 at https://www.england.nhs.uk/nhs- standard-contract/ Ongoing A, CR
Mental health
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
Patient safety
E.A.S.4 Zero tolerance methicillin- resistant Staphylococcus aureus >0 See https://www.england.nhs.uk/patient- safety/healthcare-associated- infections/ Ongoing A
E.A.S.5 Minimise rates of Clostridium difficile (NHS Trusts / FTs only) As published by NHS England at https://www.england. nhs.uk/patient- safety/healthcare- associated- infections/ See https://www.england.nhs.uk/patient- safety/healthcare-associated- infections/ Year A
Minimise rates of gram-negative bloodstream infections (NHS Trusts / FTs only) As published by NHS England at https://www.england. nhs.uk/patient- safety/healthcare- associated- infections/ See https://www.england.nhs.uk/patient- safety/healthcare-associated- infections/ Year A
VTE risk assessment: all inpatient Service Users 95% (based on a sample of 100 See Contract Technical Guidance Appendix 2 at Quarter A
Ref National Quality Requirement Threshold Guidance on definition Period over which the Standard is to be achieved Service category
undergoing risk assessment for VTE Service Users each Quarter) https://www.england.nhs.uk/nhs- standard-contract/
Proportion of Service User inpatients who undergo sepsis screening and who, where screening is positive, receive IV antibiotic treatment within one hour of diagnosis Operating standard of 90% (based on a sample of 50 Service Users each Quarter) See Contract Technical Guidance Appendix 2 at https://www.england.nhs.uk/nhs- standard-contract/ Quarter A
Duty of candour
Duty of candour Each failure to notify the Relevant Person of a suspected or actual Notifiable Safety Incident in accordance with Regulation 20 of the 2014 Regulations See CQC guidance on Regulation 20 at: https://www.cqc.org.uk/guidance- providers/regulations- enforcement/regulation-20-duty- candour Ongoing All
Community
Values
POD POD Sum of Activity Sum of Price
Actual Actual
Values
POD POD Sum of Activity Sum of Price
Actual Actual
Activity Finance
1 71,374
22/23 plan 23/24 plan 24/25 plan*
Devices £0 £0 £0
Diagnostics £807,936 £817,370 £734,215
Drugs £567,639 £577,856 £520,962
Elective £155,854 £157,915 £269,568
ITU £0 £0 £0
Non Elective £88,975 £90,168 £110,639
Outpatient £827,373 £840,531 £800,471
XBDs Z other £141,959 £305,260 £144,514 £310,581 £149,638 £764,117
23/24 plan 23/24 actual** 24/25 plan
Devices £0 £0 £0
Diagnostics £817,370 £713,544 £734,215
Drugs £577,856 £506,281 £520,962
Elective £157,915 £261,971 £269,568
ITU £0 £0
Non Elective Outpatient £90,168 £840,531 £107,521 £777,915 £110,639 £800,471
XBDs £144,514 £145,423 £149,638
Z other £310,581 £742,583 £764,117
Area Basis 2023/24 £'s Notes
Consultant Time into clinics 6.56 PAs £101,929
Consultant time into MDT’s 3 x each weekly (1 x MO, 1 x CO, 1 x HO) £52,271
Staff grade time 4 PA’s £33,882
Specialist nurse time 0.5 wte mid-pt Band 7 with on-costs £28,000
Access to Triage hotline and IO service 0.2 wte mid-pt Band 7 with on-costs £19,435
Pharmacy Support Mid-pt Band 8A with on-costs £68,420
IT support • Service desk support • EPR team support • e- prescribing system support • training £60,346
Admin support As previous £29,447
Overheads 10% £38,550
Total cost £432,281
Row Labels Sum of Activity Sum of Price
Plan Plan
Row Labels Sum of Activity Sum of Activity Sum of Activity Diff Sum of Price Sum of Price Sum of Price
Plan Actual Actual-Plan Plan Actual Diff Actual-Plan
Planned P rPlanned Procedure Estimate HRG Tariff Pathway C Pathway S Local Iden tNHS Num bReferral Date TCI Date Waiting Li sR eferral Pr Source of RReferred t oW aiting Lis A dmission Waiting Lis W aiting Lis W aiting Lis P Code
C893 C893 Injection of therapeutic substance into posterior segment of eye NEC BZ86 £325 ACTIVE Royal RQ666548 4.29E+09 13/02/2025 00:00 09/12/2025 13:00 ######## Routine Internal Ophthalmo IPNJ DIAB: Elective - P 130 Ophthalmo Rou tine P3
C848 C848 Other specified other operations on retina BZ84 £770 ACTIVE Royal RQ655044 4.29E+09 10/11/2025 00:00 12/11/2025 08:00 ######## Routine Optometris Ophthalmo ISTD C: Mi sEl ectiv e - B 130 Ophthalmo Rou tine P2
ACTIVE Royal RQ662372 4.49E+09 15/01/2025 16:09 ######## Routine Consultant Upper Gas Admitted U E lec tive - W 1 06 Upper Gas Routine P 0
ACTIVE Aintree RQ668810 6.27E+09 31/10/2025 00:00 11/11/2025 09:30 ######## 2 Week Ru Consultant Maxillofaci aIP AUH O r aE lective - P 140 Oral Surge 2 Week Ru P2
G071 G071 Closure of tracheo-oesophageal fistula FF02 £5,871 ACTIVE Aintree RQ666679 4.29E+09 29/07/2025 00:00 ######## Routine Internal Ear Nose aID A UH EN El ective - W 1 20 Ear Nose aRo utine Unknown
B083 B083 Hemithyroidectomy KA09 £3,850 ACTIVE Aintree RQ660379 4.29E+09 29/10/2025 00:00 28/11/2025 11:30 ######## Urgent Consultant Ear Nose aID A UH EN El ective - W 1 20 Ear Nose aRo utine P0
C546 C546 Removal of implant or explant from sclera BZ84 £770 ACTIVE Royal RQ668745 4.42E+09 12/08/2025 00:00 13/11/2025 08:00 ######## Routine Orthoptist Ophthalmo IHHD C: Pr oE lective - B 130 Ophthalmo Rou tine P2
J459 J459 Unspecified diagnostic endoscopic retrograde examination of pancreatic duct GB11 £1,056 ACTIVE Aintree RQ668831 4.29E+09 30/10/2025 00:00 19/11/2025 09:45 ######## Routine Other Gastroente DC AU H E Elective - P 301 Gastroente Routin e Unknown
J459 J459 Unspecified diagnostic endoscopic retrograde examination of pancreatic duct GB11 £1,056 ACTIVE Aintree RQ668876 4.29E+09 30/10/2025 00:00 ######## Routine Other Gastroente DC AU H E Elective - P 301 Gastroente Routin e Unknown
ACTIVE Royal RQ654482 6.35E+09 18/07/2025 00:00 19/01/2026 12:30 ######## Routine Cons resp Op htha l mo ISTD C: Mi sEl ectiv e - W 1 30 Ophthalmo Rou tine P3
L473 L473 Arteriography of visceral branch of abdominal aorta NEC YR25 £1,538 ACTIVE Aintree RQ666775 4.58E+09 17/10/2025 00:00 04/12/2025 08:30 ######## Routine Internal Interventio nID AUH Int eEl ective - B 811 Interventio Ro utine Un known
ACTIVE Royal RQ654313 4.29E+09 09/10/2025 11:02 06/11/2025 10:30 ######## Urgent Other Colorectal IAHMSU R: Ele cti ve - W 1 04 Colorectal Routine P0
ACTIVE Royal RQ668867 4.49E+09 17/10/2025 00:00 17/11/2025 10:00 ######## Routine Consultant General S uIGSLW H: GElective - W 1 00 Gen eral S uRo utin e P0
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Royal RQ649319 4.39E+09 10/03/2025 00:00 11/11/2025 07:30 ######## Urgent Consultant Trauma an A dmitted F Ele c tive - W 1 10 Trauma an R outine P3
C231 C231 Insertion of weight into upper eyelid BZ44 £1,186 ACTIVE Aintree RQ668296 4.68E+09 03/12/2024 00:00 ######## Urgent Consultant Ophthal mo DC A UH O Ele ctive - W 1 30 Ophthalmo Rou tine Unknown
C712 C712 Phacoemulsification of lens BZ32 £838 ACTIVE Royal RQ668710 4.29E+09 23/07/2025 00:00 24/11/2025 07:30 ######## Routine Cons resp Op htha l mo IPCA T: Ca Electi ve - B 130 O phthalmo Rou tine P3
C801 C801 Peel of epiretinal fibroglial membrane BZ84 £770 ACTIVE Royal RQ656124 6.35E+09 31/07/2025 00:00 26/11/2025 12:30 ######## Routine Cons resp Op htha l mo IMTS DC: MEl ec tive - B 130 Op hthalmo Rou tine P3
C463 C463 Penetrating graft to cornea BZ61 £1,267 ACTIVE Royal RQ668406 6.49E+09 07/02/2025 00:00 ######## Routine Cons resp Op htha l mo COR NCL: Elective - W 1 30 Ophthalmo Rou tine P3
J459 J459 Unspecified diagnostic endoscopic retrograde examination of pancreatic duct GB11 £1,056 ACTIVE Aintree RQ668473 4.53E+09 07/10/2025 00:00 ######## Routine Other Gastroente DC AU H E Elective - P 301 Gastroente Routin e Unknown
ACTIVE Royal RQ655158 4.29E+09 19/03/2025 00:00 ######## Routine Internal Colorectal Admitted C Elective - W 1 04 Colorectal Routine P0
ACTIVE Royal RQ668789 4.83E+09 08/09/2025 00:00 ######## Routine Consultant Trauma an A dmitted L oElec tive - W 1 10 Trauma an R outine P0
ACTIVE Royal RQ667012 6.48E+09 11/12/2024 00:00 13/11/2025 07:30 ######## Routine Internal Colorectal Admitted C Elective - W 1 04 Colorectal Routine P2
Z942 Z942 Right sided operation UZ05 £0 ACTIVE Aintree RQ668175 4.57E+09 01/10/2024 00:00 ######## Urgent Consultant Ophthalmo DC A UH O Ele ctive - W 1 30 Ophthalmo Urge nt P3
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Aintree RQ666107 6.24E+09 23/12/2021 00:00 01/12/2025 07:30 ######## Routine Internal Ophthalmo DC A UH O Ele ctive - W 1 30 Ophthalmo Urge nt P3
O389 O389 Unspecified reverse polarity total prosthetic replacement of shoulder joint not using cement HN52 £6,486 ACTIVE Royal RQ656413 4E+09 10/07/2025 00:00 ######## Routine Internal Trauma an A dmitted S Elec tive - W 1 10 Trauma an R outine P2
C802 C802 Peel of internal limiting membrane BZ84 £770 ACTIVE Royal RQ668720 4.29E+09 25/07/2025 00:00 08/01/2026 12:30 ######## Routine Cons resp Op htha l mo IPCO PH: ME lec tive - B 13 0 Ophthalmo Rou tine P4
ACTIVE Royal RQ668805 4.2E+09 16/09/2025 00:00 29/09/2025 10:30 ######## Routine Consultant General S uIGSLW H: GElective - W 1 00 Gen eral S uRo utin e P0
C463 C463 Penetrating graft to cornea BZ61 £1,267 ACTIVE Royal RQ647740 4.29E+09 19/08/2015 00:00 ######## Routine General M eOphth almo GRA FT: O Elective - W 1 30 Opht halmo Rou tine P3
E036 E036 Septoplasty of nose NEC CA11 £2,132 ACTIVE Aintree RQ667305 4.29E+09 18/07/2024 09:07 ######## Routine Internal Ear Nose aID A UH EN El ective - W 1 20 Ear Nose aRo utine P4
C121 C121 Excision of lesion of eyelid NEC BZ46 £594 ACTIVE Aintree RQ668271 6.46E+09 19/11/2024 00:00 ######## Urgent Consultant Ophthal mo IP A UH Op Elective - W 1 30 Ophthalmo Urge nt P3
C893 C893 Injection of therapeutic substance into posterior segment of eye NEC BZ86 £325 ACTIVE Royal RQ666548 4.29E+09 13/02/2025 00:00 ######## Routine Internal Ophthalmo IPNJ DIAB: Elective - P 130 Ophthalmo Rou tine P3
Z942 Z942 Right sided operation UZ05 £0 ACTIVE Aintree RQ668698 6.18E+09 15/07/2025 00:00 ######## Urgent Consultant Ophthalmo PB A UH O Elective - W 1 30 Ophthalmo Rou tine P4
ACTIVE Royal RQ667554 4.29E+09 22/01/2025 12:07 ######## Routine Consultant Upper Gas IHERNIA: CE lective - W 1 00 General S uRoutin e P0
C712 C712 Phacoemulsification of lens BZ32 £838 ACTIVE Royal RQ666548 4.29E+09 13/02/2025 00:00 28/11/2025 12:30 ######## Routine Internal Ophthalmo IPCA T: Ca Electi ve - W 1 30 O phthalmo Rou tine P3
C522 C522 Deep sclerectomy without spacer BZ92 £1,480 ACTIVE Royal RQ668196 6.19E+09 11/10/2024 00:00 02/12/2025 12:30 ######## Routine Cons resp Op htha l mo ICRY ADC: Ele cti ve - B 130 Ophthalmo Rou tine P3
C151 C151 Correction of ectropion NEC BZ44 £1,186 ACTIVE Aintree RQ652314 4.29E+09 10/10/2024 00:00 ######## Routine Internal Ophthalmo DC A UH O Ma ternity a 130 Ophthalmo Rou tine Unknown
ACTIVE Royal RQ648121 4.28E+09 07/08/2025 00:00 ######## Routine Consultant Vascular S IENDO VAS Ele ctive - W 1 07 Vascular S Routin e P2
J459 J459 Unspecified diagnostic endoscopic retrograde examination of pancreatic duct GB11 £1,056 ACTIVE Aintree RQ646839 4.29E+09 19/08/2025 00:00 ######## Routine Other Gastroente DC AU H E Elec tive - P 301 Gastroente Routin e Unknown
C463 C463 Penetrating graft to cornea BZ61 £1,267 ACTIVE Royal RQ647223 4.29E+09 26/10/2007 10:44 ######## Routine Consultant Ophthalmo GRA FT: O Elective - W 1 30 Opht halmo Rou tine P4
Z942 Z942 Right sided operation UZ05 £0 ACTIVE Aintree RQ667884 7.27E+09 19/04/2024 00:00 ######## Routine Consultant Ophthalmo PB A UH O Elective - W 1 30 Ophthalmo Rou tine P4
C498 C498 Other specified incision of cornea BZ63 £966 ACTIVE Royal RQ667851 7.31E+09 04/04/2024 00:00 ######## Routine Cons resp Op htha l mo IPMI N: Min Elective - W 1 30 Ophthalmo Rou tine P4
ACTIVE Royal RQ667253 6.26E+09 27/04/2023 13:05 ######## Routine Consultant Upper Gas IHERNIA: CE lective - W 1 00 General S uRoutin e P0
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Aintree RQ660061 4.86E+09 12/06/2025 00:00 ######## Routine Consultant Ophthalmo PB A UH O Elective - W 1 30 Ophthalmo Rou tine P4
M459 M459 Unspecified diagnostic endoscopic examination of bladder LB72 £299 ACTIVE Aintree RQ655830 4.28E+09 11/12/2024 00:00 ######## Urgent Consultant Urology Se DC AUH E Elective - P 101 Urology Se Urgent Unknown
ACTIVE Aintree RQ668600 6.06E+09 29/05/2025 00:00 ######## Urgent Consultant Ear Nose aID A UH EN El ective - W 1 20 Ear Nose aUrg ent P0
C321 C321 Recession of medial rectus muscle of eye NEC BZ73 £1,507 ACTIVE Aintree RQ666478 4.79E+09 28/05/2025 00:00 ######## Routine Consultant Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine P4
ACTIVE Royal RQ652885 4.28E+09 09/04/2025 11:39 ######## Urgent Internal Trauma an A dmitted L oElec tive - W 1 10 Trauma an U rgent P3
C322 C322 Recession of lateral rectus muscle of eye NEC BZ73 £1,507 ACTIVE Aintree RQ668194 7.07E+09 10/10/2024 00:00 ######## Routine Consultant Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine P4
M093 M093 Endoscopic laser fragmentation of calculus of kidney LB64 £2,737 ACTIVE Aintree RQ668471 4.29E+09 14/03/2025 00:00 12/12/2025 07:30 ######## Urgent Consultant Urology Se IP AUH Ur oE lective - W 1 01 Urolo gy Se Urgent P2
ACTIVE Royal RQ666454 4.68E+09 27/06/2025 00:00 ######## Routine General M eColor ectal Admitted C Elective - W 1 04 Colorectal Routine P0
W742 W742 Reconstruction of intra-articular ligament NEC HN93 £1,762 ACTIVE Royal RQ668616 6.49E+09 28/05/2025 00:00 19/11/2025 07:30 ######## Routine Consultant Trauma an A dmitted L oElec tive - W 1 10 Trauma an R outine P4
Z942 Z942 Right sided operation UZ05 £0 ACTIVE Aintree RQ646785 4.29E+09 09/09/2022 00:00 ######## Routine Consultant Ophthalmo DC A UH O Ele ctive - W 1 30 Ophthalmo Rou tine P4
C321 C321 Recession of medial rectus muscle of eye NEC BZ73 £1,507 ACTIVE Royal RQ667858 6.32E+09 08/04/2024 00:00 ######## Routine Consultant Ophthalmo IPMA OPH E lective - W 1 30 Opht halmo Rou tine P4
C311 C311 Recession of medial rectus muscle and resection of lateral rectus muscle of eye BZ72 £1,960 ACTIVE Aintree RQ668613 4.29E+09 28/05/2025 00:00 ######## Routine Consultant Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine P4
C465 C465 Deep lamellar graft to cornea BZ60 £1,691 ACTIVE Royal RQ668052 5E+09 22/07/2024 00:00 ######## Routine Cons resp Oph t halm o GRA FT: O Elective - W 1 30 Opht halmo Rou tine P4
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Aintree RQ668600 4.29E+09 21/05/2025 00:00 ######## Routine Consultant Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine P4
C848 C848 Other specified other operations on retina BZ84 £770 ACTIVE Royal RQ645083 4.29E+09 07/10/2024 00:00 ######## Routine Cons resp Op htha l mo IMTS DC: MEl ec tive - B 130 Op hthalmo Rou tine P4
Z942 Z942 Right sided operation UZ05 £0 ACTIVE Aintree RQ661391 4.41E+09 18/11/2024 00:00 ######## Routine Internal Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine P4
C463 C463 Penetrating graft to cornea BZ61 £1,267 ACTIVE Royal RQ652398 4.29E+09 19/05/2023 00:00 ######## Routine Cons resp Op htha l mo GRA FT: O Elective - W 1 30 Opht halmo Rou tine Unknown
ACTIVE Royal RQ668468 4.41E+09 13/03/2025 16:45 ######## Routine Consultant Upper Gas Admitted U E lec tive - B 106 Upper Gas Routine P 0
C323 C323 Recession of superior rectus muscle of eye BZ72 £1,960 ACTIVE Royal RQ651369 6.11E+09 08/11/2023 00:00 ######## Routine Cons resp Op htha l mo ICM DYDC : Ele ctive - W 1 30 Ophthalmo Rou tine P4
D101 D101 Radical mastoidectomy NEC CA30 £4,412 ACTIVE Aintree RQ655267 4.6E+09 11/12/2024 00:00 ######## Routine Consultant Ear Nose aID A UH EN El ective - W 1 20 Ear Nose aUrg ent P3
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Aintree RQ650959 4E+09 19/08/2024 00:00 ######## Routine Consultant Ophthal mo PB A UH O Elective - W 1 30 Ophthalmo Rou tine P4
ACTIVE Royal RQ668390 4.42E+09 30/01/2025 11:14 ######## Routine Other Trauma an A dmitted L oElec tive - W 1 10 Trauma an R outine P0
W169 W169 Unspecified other division of bone HN34 £2,226 ACTIVE Royal RQ652668 6.33E+09 17/12/2024 12:05 ######## Routine Other Trauma an A dmitted L Ele c tive - W 1 10 Trauma an R outine P4
ACTIVE Royal RQ667215 6.2E+09 20/04/2023 18:06 ######## Emergenc yOther Trauma an A dmitted S Elec tive - W 1 10 Trauma an R outine P4
C328 C328 Other specified recession of muscle of eye BZ73 £1,507 ACTIVE Royal RQ645999 4.29E+09 24/08/2018 00:00 ######## Routine Cons resp Op htha l mo ISBK OPH: Elec tive - B 130 Ophthalmo Rou tine P4
C316 C316 Recession of lateral rectus muscle and resection of medial rectus muscle of eye BZ72 £1,960 ACTIVE Aintree RQ648330 4.79E+09 25/02/2025 00:00 20/11/2025 12:00 ######## Routine Internal Ophthalmo ID A UH Op El ective - W 1 30 Ophthalmo Rou tine Unknown
Z943 Z943 Left sided operation UZ05 £0 ACTIVE Aintree RQ667653 4.29E+09 12/12/2023 00:00 25/11/2025 07:30 ######## Routine Consultant Ophthalmo PB A UH O Elective - P 130 Ophthalmo Rou tine P4
J439 J439 Unspecified diagnostic endoscopic retrograde examination of bile duct and pancreatic duct GB11 £1,056 ACTIVE Aintree RQ668232 4.86E+09 30/10/2024 00:00 28/11/2025 09:00 ######## Routine Other Gastroente DC AU H E Elec tive - P 301 Gastroente Routin e C4
W629 W629 Unspecified other primary fusion of other joint HC63 £5,022 ACTIVE Royal RQ660297 4.29E+09 09/11/2021 00:00 ######## Routine Internal Trauma an A dmitted L Ele c tive - W 1 10 Trauma an R outine P4
Active OP WL for IOM patients as at 12/11/25 IPWL
OPFASPL plus MFF Total Active patients only
Cardiology 1 £209 £209 71 patients - 35 with no TCI but have Procedure code + 18 patients with TCI and procedure code + 18 patients with no TCI or Procedure code
Colorectal 2 £184 £367 TCI/Procedure code £20,522
Dietetics 1 £47 £47 No TCI/Procedure Code £51,349
ENT 10 £156 £1,559 No TCI or Procedure co d £0
Endocrinology 2 £288 £577 £71,871
Gastro 2 £251 £503
HPB 1 £315 £315
Hepatology 5 £341 £1,703 Caveat
MFU 2 £177 £355 won't take account of any patient comorbidites
Ophthalmology 90 £166 £14,957 won't take account of Length of stay and therefore potential XBDs
Oral Surgery 2 £166 £332 won't take account of any critical care, pass through drugs and devices
Respiratory 3 £264 £791 estimate HRG based on WL procedure code only, in primary position
Rheumatology 3 £331 £994 WL is a moving beast and this is a snapshot based on point in time
SLT 1 £80 £80
T&O 13 £198 £2,574
Urology 9 £169 £1,523
Vascular 5 £227 £1,134
152 £3,570 £28,020
Active IPWL £71,871
Costed Estimate of Active WL £99,891
RQ6Numb Forename Surname Admission Admission Admission LengthOfS Actual Man GPPractic ePostcode WardCode Date TreatmentFunctionDescription
RQ654567 xxxx xxxx Renal Med ######## 49 Emergenc yY 00944 IM1 2PG Not Recorded
RQ666454 xxxx xxxx Gastroente ######## 58 Elective Ad Y00944 IM1 2PG Not Recorded
Applied filters:OpenSpellFlag is 1LengthOfStayToDateDays is greater than or equal to 30WardSite is not XXPL TEST SITEPostcode starts with 'IM'
RQ6Numb Forename Surname Admission Admission Admission Spell LoS Actual Man GPPractic ePostcode Discharge Discharge Discharge Specialty
RQ668803 xxxx xxxx Emergenc y # ####### 49 Emergenc yY 00944 IM1 2PG AWMTW ######## Trauma and Orthopaedic Service
RQ668453 xxxx xxxx Gastroente ######## 31 Elective Ad Y00008 IM2 7EA RW4A ######## Hepatology Service
RQ668723 xxxx xxxx General S u ######## 41 Emergenc yY 00009 IM9 2RQ RW5C ######## General Surgery Service
RQ667112 xxxx xxxx General S u ######## 32 Elective Ad Y00010 IM3 4EA RW5C ######## Upper Gastrointestinal Surgery Service
RQ660771 xxxx xxxx Hepatobilia # ##### ## 116 Elective Ad Y00007 IM2 3TD RW5C ######## Hepatobiliary and Pancreatic Surgery Service
RQ668615 xxxx xxxx Ear Nose a # ###### 69 Emergenc yY 00005 IM1 4QA AW28 ######## Ear Nose and Throat Service
RQ649912 xxxx xxxx Vascular S ######## 47 Emergenc yY 00944 IM1 2PG AW03 ######## Vascular Surgery Service
RQ668549 xxxx xxxx General S u ######## 36 Emergenc yY 00003 IM8 3EY RW5C ######## Upper Gastrointestinal Surgery Service
RQ668484 xxxx xxxx Infectious ######## 34 Emergenc yY 00004 IM9 6BD RWLNGE ######## Infectious Diseases Service
RQ667776 xxxx xxxx General S u ######## 30 Elective Ad Y00008 IM2 7EA RW5C ######## General Surgery Service
RQ668379 xxxx xxxx Hepatobilia ###### ## 37 Elective Ad Y00004 IM9 6BD RW5A ######## Hepatobiliary and Pancreatic Surgery Service
RQ660004 xxxx xxxx Colorectal A######## 33 Elective Ad Y00007 IM2 3TD RW5D ######## Colorectal Surgery Service
RQ652398 xxxx xxxx Upper Gas # ####### 51 Elective Ad Y00007 IM2 3TD RW5C ######## Upper Gastrointestinal Surgery Service
RQ668354 xxxx xxxx Trauma an ## ##### 38 Elective Ad Y00004 IM9 6BD W3 ######## Trauma and Orthopaedic Service
RQ668137 xxxx xxxx General S u ######## 52 Emergenc yY 00944 IM1 2PG RW5C ######## Upper Gastrointestinal Surgery Service
RQ667351 xxxx xxxx Infectious ######## 104 Emergenc yY 00009 IM9 2RQ RW8A ######## Infectious Diseases Service
RQ668142 xxxx xxxx Renal Med ### ##### 67 Emergenc yY 00944 IM1 2PG RW8A ######## Infectious Diseases Service
Total 867
Applied filters:Date 13/11/2024 - 12/11/2025LengthOfStayDays is greater than or equal to 30WardSite is not XXPL TEST SITEPostcode starts with 'IM'
DATE OF CONTRACT June 2025
EXPECTED SERVICE COMMENCEMENT DATE 1 April 2025
CONTRACT TERM The initial term of this agreement shall be one (1) years, commencing on ______ and concluding on _____ 2026. Upon expiration of the initial term, the parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C
COMMISSIONERS Manx Care (a statutory board of the Isle of Man Government) Noble’s Hospitals Estate Strang Braddan Isle of Man IM4 4RJ
CO-ORDINATING COMMISSIONER See GC10 and Schedule 5C N/A
PROVIDER Liverpool University Hospitals NHS Foundation Trust Prescot Street Liverpool Merseyside L7 8XP ODS: REM
CONTRACT AWARD PROCESS See s15 of the Contract Technical Guidance Award in accordance with rules under Isle of Man Government Financial Regulations
SERVICE COMMENCEMENT AND CONTRACT TERM
Effective Date See GC2.1
Expected Service Commencement Date See GC3.1 1 April 2025
Longstop Date See GC4.1 and 17.10.1
Contract Term The initial term of this Contract shall be one (1) year, commencing on 1 April 2025 and concluding on 31 March 2026. The parties may mutually agree to extend the contract by up to 24 months in accordance with Schedule 1C.
Commissioner option to extend Contract Term See Schedule 1C, which applies only if YES is indicated here YES By up to 24 months.
Commissioner Notice Period (for termination under GC17.2) 60 days
Commissioner Earliest Termination Date (for termination under GC17.2) 6 months after the Service Commencement Date
Provider Notice Period (for termination under GC17.3) 60 days
Provider Earliest Termination Date (for termination under GC17.3) 6 months after the Service Commencement Date
SERVICES
Service Categories Indicate all categories of service which
the Provider is commissioned to
provide under this Contract.
Note that certain provisions of the Service
Conditions and Annex A to the Service
Conditions apply in respect of some
service categories but not others.
Accident & Emergency (A&E) Services Emergency medical care for patients with acute illnesses, injuries, or medical emergencies.
Medical Services Including but not limited to: General medicine: Diagnosis, treatment, and management of various medical conditions. Specialty clinics: Specialized clinics for specific medical conditions, such as diabetes, hypertension, and infectious diseases.
Surgical Services Including but not limited to: General surgery: Surgical procedures for common surgical conditions. Orthopaedic surgery: Treatment for musculoskeletal injuries and conditions. Neurosurgery: Surgical treatment for neurological conditions, including brain and spinal surgeries. Cardiothoracic surgery: Surgical procedures related to the heart and chest. Urology: Diagnosis and treatment of urinary tract disorders and conditions. Ear, Nose, and Throat (ENT) surgery: Surgical treatment for conditions affecting the ear, nose, and throat.
Gastroenterology and Hepatology Services Gastroenterology clinics: Diagnosis and treatment of gastrointestinal disorders, including conditions affecting the stomach, intestines, liver, pancreas, and gallbladder. Hepatology clinics: Diagnosis and management of liver diseases, including hepatitis, cirrhosis, and liver cancer. Endoscopy services: Diagnostic and therapeutic procedures such as gastroscopy, colonoscopy, and liver biopsy. Liver transplant services: Evaluation, preparation, and post-transplant care for patients requiring liver transplantation.
Ophthalmology Services Ophthalmology clinics: Diagnosis and treatment of eye conditions and diseases, including cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Ophthalmic imaging: Diagnostic tests such as optical coherence tomography (OCT) and fundus photography for assessing eye health and diagnosing eye conditions.
Haematology Services Haematology clinics: Diagnosis and treatment of blood disorders, including anaemia, bleeding disorders, and blood cancers such as leukaemia, lymphoma, and myeloma. Blood transfusion services: Provision of
blood products and transfusion support for patients undergoing surgery, chemotherapy, or experiencing blood loss.
Rheumatology Services Rheumatology clinics: Diagnosis and management of rheumatic diseases and autoimmune conditions, including rheumatoid arthritis, lupus, psoriatic arthritis, and ankylosing spondylitis. Biologic therapy: Administration of biologic medications for controlling inflammation and disease progression in rheumatic conditions.
Stroke Services Suspected stroke patients are seen immediately by stroke specialists, avoiding emergency department visits. Includes Aintree’s hyper-acute stroke service at located on the The Walton Centre NHS Foundation Trust site. Thrombectomy (via Walton Centre), available 24/7, significantly increasing the number of Isle of Man patients who can receive this treatment within the required time window. Patients who have received treatment at The Walton Centre and need ongoing care may transition to LUFHT for continued support.
Respiratory Services Respiratory clinics: Diagnosis and management of respiratory conditions.
Critical Care Services Intensive care units (ICUs): Critical care for patients with life-threatening conditions. High-dependency units (HDUs): Intermediate level of care for patients requiring close monitoring.
Diagnostic Imaging Services X-ray, CT scan, MRI, PET CT, ultrasound: Imaging services for diagnostic purposes. Interventional radiology: Minimally invasive procedures guided by imaging techniques.
Pathology Services Laboratory testing: Analysis of blood, tissue, and other specimens for diagnostic purposes. Provision of technical oversight and clinical advice, including professional judgement of individual cases, for Haematology laboratory activities. Histopathology: Examination of tissue samples for pathological analysis.
Dental Services (The Liverpool University Dental Hospital) General dentistry: Routine dental care and preventive services. Specialty clinics: Specialized dental services such as orthodontics, oral surgery, and periodontics.
Cancer Services Oncology clinics: Diagnosis, treatment, and management of cancer. Chemotherapy and radiotherapy: Cancer treatment modalities. Palliative care: Supportive care for patients with advanced cancer.
Cardiology Services Cardiac clinics: Diagnosis and treatment of heart conditions. Cardiac catheterization lab: Interventional procedures for heart conditions.
Renal Services Nephrology clinics: Diagnosis and treatment of kidney disorders.
Renal dialysis: Haemodialysis and peritoneal dialysis services.
Service Requirements
Prior Approval Response Time Standard See SC29.21 Within [ ] Operational Days following the date of request Or Not applicable
GOVERNANCE AND REGULATORY
Provider’s Nominated Individual See SC1.4
Provider’s 2018 Act Responsible Person See SC3.17 N/A
Commissioners’ UEC DoS Leads See SC6.18
Provider’s UEC DoS Contact See SC6.18
Provider’s Health Inequalities Lead (NHS Trusts and NHS Foundation Trusts only) See SC13.8
Provider’s Net Zero Lead (NHS Trusts and NHS Foundation Trusts only) See SC18.2
Provider’s Infection Prevention Lead See SC21.1
Provider’s Accountable Emergency Officer See SC30.1
Provider’s Child Sexual Abuse and Exploitation Lead See SC32.2
Provider’s Mental Capacity and Liberty Protection Safeguards Lead See SC32.2
Provider’s Prevent Lead See SC32.2
Provider’s Safeguarding Lead (adults) / named professional for safeguarding adults See SC32.2
Provider’s Safeguarding Lead (children) / named professional for safeguarding children See SC32.2
Provider’s Controlled Drugs Accountable Officer (NHS Trusts, NHS Foundation Trusts and English Independent Hospitals only) See SC33.12
Provider’s Wellbeing Guardian (NHS Trusts and NHS Foundation Trusts only) See GC5.9
Provider’s Freedom To Speak Up Guardian(s) See GC5.10
Provider’s Caldicott Guardian See GC21.3
Provider’s Data Protection Officer (if required by Data Protection Legislation) See GC21.3
Provider’s Information Governance Lead See GC21.3
Provider’s Senior Information Risk Owner See GC21.3
CONTRACT MANAGEMENT
Addresses for service of Notices See GC36 Commissioner: Manx Care Noble’s Hospital Estate, Strang, Braddan IM4 4RJ Email: Provider: Liverpool University Hospitals NHS Foundation Trust Prescot Street Liverpool Merseyside L7 8XP Email: [ ]
Frequency of Review Meetings See GC8.1 Monthly, but will be reviewed during the Contract Term to a frequency not greater than Quarterly.
Commissioner Representative(s) See GC10.3
Provider Representative See GC10.3
Nominated Mediation Body (where required – see GC14.4) CEDR
Date Document Description
Diagnostics available on-island.docx Outlines the diagnostic and investigative services available on the Isle of Man. It serves to inform UK providers about what can be conducted locally in the Isle of Man, reducing the need for patients to travel off- island.
Service name Elective and Non elective services (as listed in the Service Categories)
Service specification number N/A
Population and/or geography to be served Residents of the Isle of Man
Service aims and desired outcomes The Provider shall deliver tertiary and acute healthcare services to Isle of Man patients with access and clinical outcomes equivalent to those available to UK residents accessing the Provider’s services. The aims include: Ensuring timely, high-quality, and equitable healthcare provision. Supporting a close working relationship with the Commissioner’s (Manx Care) clinicians, including clear and inclusive arrangements for Multi-Disciplinary Teams (MDTs). Optimising patient care through efficient use of on-island and off-island resources, reducing unnecessary travel and follow- up appointments where possible.
Service description and location(s) from which it will be delivered The Provider shall deliver a range of elective and non-elective services, primarily at its site(s) in Liverpool, with some services delivered partly on the Isle of Man (e.g., via visiting clinics, virtual consultations, or local delivery by the Commissioner (Manx Care) with Provider support). The list of services below is indicative and may be personalised based on individual patient needs. Services include: Accident & Emergency (A&E) Services Emergency medical care for patients with acute illnesses, injuries, or medical emergencies. Medical Services Including but not limited to: General medicine: Diagnosis, treatment, and management of various medical conditions. Specialty clinics: Specialized clinics for specific medical conditions, such as diabetes, hypertension, and infectious diseases. Surgical Services Including but not limited to: General surgery: Surgical procedures for common surgical conditions. Orthopaedic surgery: Treatment for musculoskeletal injuries and conditions.
Section/Clause 2025/26 NHS Manx Care Adjustment Rationale
Standard
Contract
SC1.1 Deliver Services in accordance with NHS England’s national priorities Replace with Manx Care Operating Plan https://www.manx.news/wp- content/uploads/2025/03/Manx- Care-Operating-Plan.pdf IOM uses own health strategy; 24/25 referenced NHS Long Term Plan
SC3.1.1 – 3.1.2 Elective activity recovery (52- week waits, diagnostics within 6 weeks) Optional; applies only if specified in Service Specifications for off-island services Assess relevance to IOM off-island scope; not mandatory
SC6.1, SC6.10 Right to Choice, NHS Constitution, elective pathways, digital referrals Exception - Choice to realign with Manx Care policies which don’t include patient choice; digital referrals retained IOM lacks NHS Constitution; tailor choice to IOM pathways (i.e. restricted choice)
SC6.10 Digital referral systems (e.g., e-Referral Service) Per IOM locally agreed referral pathways SC6.10 new in 25/26; IOM and its patients currently do not use NHS e-Referral
SC18.1–SC18.4 NHS Choice Framework Exception - Choice to realign with Manx Care policies which don’t include patient choice; digital referrals retained IOM lacks NHS Constitution and Service User legal rights to Choice; tailor choice to IOM pathways (i.e. restricted choice)
SC33 PSIRF replaces NRLS PSIRF reporting to Manx Care’s system: DatixEnquiries@gov.im 24/25 used NRLS; PSIRF new in 25/26; align with local reporting
SC36.1, SC36.4 Fixed Payment for The Commissioner (Manx Care) shall make monthly payments to the Provider IOM commissions differently than
Trusts, API adjustments based on the actual activity delivered in the respective month, as determined by the Activity Reporting submitted by the Provider. Payments will reflect the NHS Tariff unit costs (or Local tariff pricing agreed with the provider) for the services provided, as outlined in the contract schedule. On a quarterly basis, the Provider may issue a reconciliation invoice or credit note to adjust the monthly payments where necessary to the agreed actual activity levels, as verified through the Activity Reporting process. ICB given our unique situation in the region
GC5.1- GC5.8 Staff; ICB oversight Not applicable NHS/NHS E policy, not relevant to IOM as Commissioner
GC10.1–GC10.3 Co-ordinating Commissioner role Manx Care as sole Commissioner IOM is a single- commissioner model; IOM has not appointed a appointed a Co-ordinating Commissioner, hence IOM as single Commissioner applies throughout GC and SC.
GC21.1–GC21.23 Confidentiality, Data Security Toolkit, DPIAs, cyber resilience Retain 2025/26 IG standards however, reference is made to IoM Data Protection Legislation; IOM aligns with UK GDPR but uses its own local laws
Quality Requirement Threshold Method of measurement Period over which the requirement is to be achieved Applicable Service Specification
1 Insert text and/or attach spreadsheet or documents locally in respect of one or more Contract Years or state Not Applicable
2
3
4
5
Date Document
Insert text locally or state Not Applicable
Date Document
Sub-Contractor Service Description Start date/expiry date Processing If the Sub-Contractor is processing
Personal Data – Personal Data, state whether the Sub-
[Name]
Yes/No Contractor is a Data Processor OR a
[Registered Office] Data Controller OR a joint Data
Controller
[Company number]
Insert text locally or state Not Applicable
Co-ordinating Role/Responsibility
Commissioner/Commissioner
Manx Care Reviews, on an annual basis, changes to the UK’s NHS National Standard Contract Particulars, Service Conditions and General Conditions so that the Contract between Manx Care and the Provider may be updated to align with those changes (e.g. new standards); and if Manx Care and the Provider cannot agree to applying those NHS changes to Manx Care’s contract with the Provider, then the default would be the NHS National Standard Terms.
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
National Requirements Reported Centrally
1 As specified in the Schedule of Approved Collections published at https://digital.nhs.uk/isce/publication/nhs- standard-contract-approved-collections where mandated for and as applicable to the Provider and the Services As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
1a Without prejudice to 1 above, daily submissions of timely Emergency Care Data Sets, in accordance with DAPB0092-2062 and with detailed requirements published at https://digital.nhs.uk/data-and- information/data-collections-and-data-sets/data- sets/emergency-care-data-set-ecds/ecds-latest-update As set out in relevant Guidance As set out in relevant Guidance Daily A+E, U
2 Patient Reported Outcome Measures (PROMS) https://digital.nhs.uk/data-and-information/data-tools- and-services/data-services/patient-reported-outcome- measures-proms As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
National Requirements Reported Locally
1a Activity and Finance Report Monthly In the format specified in the relevant Information Standards Notice (DCB2050) [For local agreement] A, MH
1b Activity and Finance Report Monthly [For local agreement] [For local agreement] All except A, MH
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
2 Service Quality Performance Report, detailing performance against National Quality Requirements, Local Quality Requirements and the duty of candour, including, without limitation: Monthly As per that agreed with the Trust’s main commissioner Within 15 Operational Days of the end of the month to which it relates
2a details of any thresholds that have been breached and breaches in respect of the duty of candour that have occurred; All
2b details of all requirements satisfied; All
2c details of, and reasons for, any failure to meet requirements All
3 Where CQUIN applies, CQUIN Performance Report and details of progress towards satisfying any CQUIN Indicators, including details of all CQUIN Indicators satisfied or not satisfied [For local agreement] [For local agreement] [For local agreement] All
4 Complaints monitoring report, setting out numbers of [For local agreement] In accordance with ICB agreed format. [For local agreement] All
complaints received and including analysis of key
themes in content of complaints
5 Report against performance of Service Development In accordance with relevant SDIP In accordance with relevant SDIP In accordance with relevant SDIP All
and Improvement Plan (SDIP)
6 Summary report setting out relevant information on Monthly [For local agreement] In accordance with ICB agreed format. [For local agreement] All
Patient Safety Incidents and the progress of and
outcomes from Patient Safety Investigations, as
agreed with the Co-ordinating Commissioner
7 Data Quality Improvement Plan: report of progress In accordance with relevant DQIP In accordance with relevant DQIP In accordance with relevant DQIP All
against milestones
8 Report on outcome of reviews and evaluations in relation to Staff numbers and skill mix in accordance with GC5.2 (Staff) Annually (or more frequently if and as required by the Co- ordinating [For local agreement] Not Applicable [For local agreement] Not Applicable All
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
Commissioner from time to time)
9 Where the Services include Specialised Services and/or other services directly commissioned by NHS England (or commissioned by an ICB, where NHS England has delegated the function of commissioning those services), specific reports as set out at https://www.england.nhs.uk/nhs-standard-contract/dc- reporting/ (where not otherwise required to be submitted as a national requirement reported centrally or locally) As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ And Reports to be sent to: All
10 Report on progress against Green Plan in accordance with SC18.2 (NHS Trust/FT only) Annually [For local agreement] [For local agreement] All
Local Requirements Reported Locally
1 Monthly See attached details in Schedule 6 for PTL and SLAM format requirement The Provider must submit any patient- identifiable data required in relation to Local Requirements Reported Locally via the Data Landing Portal in accordance with the Data Landing Portal Acceptable Use Statement. [Otherwise, for local agreement] Reports to be sent to: In accordance to SUS timetable All
SLAMs and PLDS and any other associated patient
tracking activity and performance reports related to
Manx Care’s patients under the care of the Provider.
Data Quality Indicator Data Quality Threshold Method of Measurement Milestone Date
1 Delete the italicised guidance notes above; insert text locally or state Not Applicable
2
3
4
Milestones Timescales Expected Benefit
# Data Element Format and Length Population Guidance Notes Mandatory (M), Mandatory Where Relevant (R) or Optional (O)
1 FINANCIAL MONTH max an2 1=April, 2= May, 3 June….12=March, with no leading zeros. The month in which the census occurred. M
2 FINANCIAL YEAR an6 202425=2024/25, 202526=2025/26 etc. The slash (/) symbol must not be included. The financial year in which the census occurred. M
3 DATE AND TIME DATA SET CREATED an19 DD-MM-CCYY- hh:mm:ss Valid date and time format - as shown in the Specification. The date and time that the file was created prior to its submission. This timestamp will be used to ascertain the latest version of the submission. M
4 ORGANISATION IDENTIFIER (CODE OF PROVIDER) min an3 max an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. NHS Providers must complete this data element with their valid national 3-character Trust code with no trailing zeros (i.e. RNA not RNA00). M
5 SITE CODE (OF TREATMENT) min an5 max an9 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The ORGANISATION SITE CODE of the ORGANISATION where the PATIENT was treated. M
6 ORGANISATION IDENTIFIER (CODE OF COMMISSIONER) min an3 max an5 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The derived commissioner as derived with reference to the NHS England Commissioner Assignment Method (CAM), where possible given that the exact treatment may not be known in advance, and hierarchy for assigning NHS England directly-commissioned services. M
7 GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION) an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. National ODS code - see the NHS Digital ODS Portal for valid codes. M
8 WITHHELD IDENTITY REASON an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. To be populated where any of the patient identifiable fields are not provided due to withheld identity reasons. Where the TREATMENT FUNCTION CODE indicates activity relating to a sensitive data item e.g. HIV or G- U Medicine no patient identifiable fields should be populated and the appropriate WITHHELD IDENTITY REASON code used. R
9 NHS NUMBER n10 If the NHS NUMBER does not exist the LOCAL PATIENT IDENTIFIER (EXTENDED) must be populated. The population of this data element is not required where the WITHHELD IDENTITY REASON is populated. R
10 LOCAL PATIENT IDENTIFIER (EXTENDED) max an20 R
11 MAIN SPECIALTY CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
12 TREATMENT FUNCTION CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
13 SOURCE OF REFERRAL (FOR OUTPATIENTS) n2 Valid code - see the NHS Data Model and Dictionary website for valid codes. The source of referral of each Consultant Out-Patient Episode. M
14 REFERRER CODE an8 Valid code - see the NHS Data Model and Dictionary website for valid codes. The code of the PERSON making the REFERRAL REQUEST. M
15 PRIORITY TYPE (REFERRAL) n1 Valid code - see the NHS Data Model and Dictionary website for valid codes. The priority of the service request (referral). M
16 REFERRAL TO TREATMENT PERIOD START DATE an10 CCYY-MM-DD M
17 REFERRAL TO TREATMENT PERIOD STATUS an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. RTT status is defined as ‘the status of an activity (or anticipated activity) for the RTT period, decided by the lead care professional’ or in other words: • whether each activity is part of an RTT pathway or not; • whether the activity has started an RTT clock, stopped an RTT clock or continued an existing ticking RTT clock. M
18 REFERRAL TO PROFESSIONAL CATEGORY n1 1 = Consultant Led 2 = Nurse Led 3 = Allied Health Professional Led M
19 WAITING LIST TYPE n1 1 = Out-Patient Waiting List (First Appointment) 2 = Out-patient Waiting List (Follow Up Appointment) 3 = Elective Admission List (Daycase) 4 = Elective Admission List (Inpatient) 5 = Diagnostic List 6 = Transplant List M
20 NEXT ACTIVITY 1 = O/P Waiting List - Booked. 2 = O/P Waiting List - Not Booked. 3 = Awaiting Diagnostic - Booked. 4 = Awaiting Diagnostic - Booked - Isle of Man Team. 5 = Awaiting Diagnostic - Not Booked. 6 = Admitted Waiting List - No TCI Date 7 = Admitted Waiting List - TCI Date Offered. 8 = Watchful Wait review R
21 NEXT ACTIVITY DATE an10 DD-MM-CCYY M
22 OUT-PATIENT APPOINTMENT BOOKED DATE an10 DD-MM-CCYY R
23 TO COME IN (TCI) DATE an10 DD-MM-CCYY The TCI date is a formal offer in writing of a date of admission. R
24 INTENDED MANAGEMENT CODE an1 Valid code - see the NHS Data Model and Dictionary website for valid codes. May not be needed as Point of Delivery can be determined from WAITING LIST TYPE M
25 PLANNED PROCEDURE CODE an5 Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The intended surgical procedure of those patients with a Decision to Treat, as defined by the Office of Population Censuses and Surveys (OPCS). procedure codes R
26 PLANNED PROCEDURE DESCRIPTION min an3 max an125 Text description of Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The corresponding text description of the PLANNED PROCEDURE CODE. R
27 WAITING LIST PRIORITY (P CODE) min an1 max an2 1a = Emergency - operation needed within 24 hours 1b = Urgent - operation needed with 72 hours 2 = Surgery that can be deferred for up to 4 weeks 3 = Surgery that can be delayed for up to 3 months 4 = Surgery that can be delayed for more than 3 months Surgical priority group of the patient. R
Patient Level Contract Monitoring Data Set (CDS) Specification ht tps://www.datadictionary.nhs.uk/data_sets/supporting_data_sets/patient_level_contract_monitoring_data_set.html
SUBMISSION HEADER
To carry the submission header details.One occurrence of this group is required.
ID Mandation Data Elements
1 M FINANCIAL MONTH
2 M FINANCIAL YEAR
3 M DATE AND TIME DATA SET CREATED
4 M REPORTING TYPE INDICATOR
ORGANISATION DETAILS
To carry the Organisation details of the Provider and Commissioner.One occurrence of this group is required.
ID Mandation Data Elements
5 M ORGANISATION IDENTIFIER (CODE OF PROVIDER)
6 R ORGANISATION SITE IDENTIFIER (OF TREATMENT)
7 M ORGANISATION IDENTIFIER (GP PRACTICE RESPONSIBILITY)
8 R ORGANISATION IDENTIFIER (RESIDENCE RESPONSIBILITY)
9 M ORGANISATION IDENTIFIER (CODE OF COMMISSIONER)
10 M GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
DEMOGRAPHICS
To carry the demographic details of the patient.One occurrence of this group is required.
ID Mandation Data Elements
11 R WITHHELD IDENTITY REASON
12 R NHS NUMBER
13 R LOCAL PATIENT IDENTIFIER (EXTENDED)
14 R POSTCODE OF USUAL ADDRESS
15 R PERSON BIRTH DATE
16 R AGE AT ACTIVITY DATE (CONTRACT MONITORING)
17 R PERSON STATED GENDER CODE
18 R ETHNIC CATEGORY
CARE ACTIVITY DETAILS
To carry the care activity details.One occurrence of this group is permitted.
ID Mandation Data Elements
19 R CDS UNIQUE IDENTIFIER
20 R NON CDS UNIQUE IDENTIFIER
21 R ACTIVITY TREATMENT FUNCTION CODE
22 O LOCAL SUB-SPECIALTY CODE
23 R HOSPITAL PROVIDER SPELL IDENTIFIER
24 R OUTPATIENT ATTENDANCE IDENTIFIER
25 R EMERGENCY CARE ATTENDANCE IDENTIFIER
26 R ACTIVITY START DATE (CONTRACT MONITORING)
27 R ACTIVITY END DATE (CONTRACT MONITORING)
28 R ADJUSTED LENGTH OF STAY
29 R PACKAGE OF CARE OR YEAR OF CARE START DATE (CONTRACT MONITORING)
30 M UNBUNDLED EPISODE INDICATOR
31 R LOCAL TREATMENT CATEGORY CODE
32 R LOCAL TREATMENT CODE
33 O LOCATION OF ACTIVITY START
34 O LOCATION OF ACTIVITY END
SERVICE AGREEMENT AND COMMISSIONING DETAILS
To carry the service agreement and commissioning details.One occurrence of this group is required.
ID Mandation Data Elements
35 R PROVIDER REFERENCE NUMBER
36 R NHS SERVICE AGREEMENT LINE NUMBER
37 M COMMISSIONED SERVICE CATEGORY CODE
38 R SERVICE CODE
39 M POINT OF DELIVERY CODE
40 R POINT OF DELIVERY FURTHER DETAIL CODE
41 R POINT OF DELIVERY FURTHER DETAIL DESCRIPTION
42 O LOCAL POINT OF DELIVERY CODE
43 O LOCAL POINT OF DELIVERY DESCRIPTION
44 O LOCAL CONTRACT CODE
45 O LOCAL CONTRACT MONITORING CODE
46 O LOCAL CONTRACT MONITORING DESCRIPTION
47 O CONTRACT MONITORING ADDITIONAL DETAIL (FIRST)
48 O CONTRACT MONITORING ADDITIONAL DESCRIPTION (FIRST)
COST AND PRICING DETAILS
To carry the activity and costing details.One occurrence of this group is required.
ID Mandation Data Elements
49 R TARIFF CODE
50 M NATIONAL TARIFF INDICATOR
51 M ACTIVITY COUNT (POINT OF DELIVERY)
52 M ACTIVITY UNIT PRICE
53 M TOTAL COST
Mandation M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present. R = Required: NHS business processes cannot be delivered without this data element. O = Optional: the inclusion of this data element is optional as required for local purposes.
Type of Survey Frequency Method of Reporting Method of Publication
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
National Quarterly Pulse Survey (NQPS) (if the Provider is an NHS Trust or an NHS Foundation Trust) As required by NQPS Guidance As required by NQPS Guidance As required by NQPS Guidance
Staff Survey (appropriate NHS staff surveys where required by Staff Survey Guidance) [Other] [Insert further description locally] As required by Staff Survey Guidance As required by Staff Survey Guidance As required by Staff Survey Guidance
[Other insert locally (for example, Service User Survey, Carer Survey]
Description Details
Commissioner for which Data Processing Services are to be performed Manx Care
Subject matter of the processing Provision of specialized acute and tertiary services, including elective and non-elective cases for referred by Manx Care / Isle of Man
Duration of the processing 1 April 2025 until Contract end date.
Nature and purposes of the processing The processing involves the collection, recording, organisation, and provision of specialized healthcare services for patients referred by Manx Care. The purposes include medical treatment, diagnostics, patient care management, and maintaining health records in accordance with statutory obligations.
Type of Personal Data Patient information, including but not limited to: name, address, date of birth, medical history, diagnostic data, treatment plans, and any other relevant medical information necessary for the provision of healthcare services
Categories of Data Subject Patients (and their guardians) referred by Manx Care for specialized healthcare services.
Plan for return and destruction of the data once the processing is complete UNLESS requirement under law to preserve that type of data Data will be retained for the duration of the treatment and for a period minimum of 8 years after the conclusion of treatment or 25 years in the case of records relating to the treatment of children. Upon completion of the processing, the data will be securely returned to the Commissioner or destroyed in accordance with applicable data protection laws and regulations. If there is a legal requirement to preserve certain types of data, the Provider will notify the Commissioner and specify the reasons for the extended retention period.
Manx Care
Noble's Hospital Estate
Strang
Braddan
IM4 4RJ
DATE OF CONTRACT Feb 2026
EXPECTED SERVICE COMMENCEMENT DATE 1 April 2025
CONTRACT TERM The initial term of this agreement shall be one (1) years, commencing on ______ and concluding on _____ 2026. Upon expiration of the initial term, the parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C
COMMISSIONERS Manx Care (a statutory board of the Isle of Man Government) Noble’s Hospitals Estate Strang Braddan Isle of Man IM4 4RJ
CO-ORDINATING COMMISSIONER See GC10 and Schedule 5C N/A
PROVIDER Liverpool University Hospitals NHS Foundation Trust Prescot Street Liverpool Merseyside L7 8XP ODS: REM
CONTRACT AWARD PROCESS See s15 of the Contract Technical Guidance Award in accordance with rules under Isle of Man Government Financial Regulations
SERVICE COMMENCEMENT AND CONTRACT TERM
Effective Date See GC2.1
Expected Service Commencement Date See GC3.1 1 April 2025
Longstop Date See GC4.1 and 17.10.1
Contract Term The initial term of this Contract shall be one (1) year, commencing on 1 April 2025 and concluding on 31 March 2026. The parties may mutually agree to extend the contract by up to 24 months in accordance with Schedule 1C.
Commissioner option to extend Contract Term See Schedule 1C, which applies only if YES is indicated here YES By up to 24 months.
Commissioner Notice Period (for termination under GC17.2) 60 days
Commissioner Earliest Termination Date (for termination under GC17.2) 6 months after the Service Commencement Date
Provider Notice Period (for termination under GC17.3) 60 days
Provider Earliest Termination Date (for termination under GC17.3) 6 months after the Service Commencement Date
SERVICES
Service Categories Indicate all categories of service which
the Provider is commissioned to
provide under this Contract.
Note that certain provisions of the Service
Conditions and Annex A to the Service
Conditions apply in respect of some
service categories but not others.
Accident & Emergency (A&E) Services Emergency medical care for patients with acute illnesses, injuries, or medical emergencies.
Medical Services Including but not limited to: General medicine: Diagnosis, treatment, and management of various medical conditions. Specialty clinics: Specialized clinics for specific medical conditions, such as diabetes, hypertension, and infectious diseases.
Surgical Services Including but not limited to: General surgery: Surgical procedures for common surgical conditions. Orthopaedic surgery: Treatment for musculoskeletal injuries and conditions. Neurosurgery: Surgical treatment for neurological conditions, including brain and spinal surgeries. Cardiothoracic surgery: Surgical procedures related to the heart and chest. Urology: Diagnosis and treatment of urinary tract disorders and conditions. Ear, Nose, and Throat (ENT) surgery: Surgical treatment for conditions affecting the ear, nose, and throat.
Gastroenterology and Hepatology Services Gastroenterology clinics: Diagnosis and treatment of gastrointestinal disorders, including conditions affecting the stomach, intestines, liver, pancreas, and gallbladder. Hepatology clinics: Diagnosis and management of liver diseases, including hepatitis, cirrhosis, and liver cancer. Endoscopy services: Diagnostic and therapeutic procedures such as gastroscopy, colonoscopy, and liver biopsy. Liver transplant services: Evaluation, preparation, and post-transplant care for patients requiring liver transplantation.
Ophthalmology Services Ophthalmology clinics: Diagnosis and treatment of eye conditions and diseases, including cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Ophthalmic imaging: Diagnostic tests such as optical coherence tomography (OCT) and fundus photography for assessing eye health and diagnosing eye conditions.
Haematology Services Haematology clinics: Diagnosis and treatment of blood disorders, including anaemia, bleeding disorders, and blood cancers such as leukaemia, lymphoma, and myeloma. Blood transfusion services: Provision of
blood products and transfusion support for patients undergoing surgery, chemotherapy, or experiencing blood loss.
Rheumatology Services Rheumatology clinics: Diagnosis and management of rheumatic diseases and autoimmune conditions, including rheumatoid arthritis, lupus, psoriatic arthritis, and ankylosing spondylitis. Biologic therapy: Administration of biologic medications for controlling inflammation and disease progression in rheumatic conditions.
Stroke Services Suspected stroke patients are seen immediately by stroke specialists, avoiding emergency department visits. Includes Aintree’s hyper-acute stroke service at located on the The Walton Centre NHS Foundation Trust site. Thrombectomy (via Walton Centre), available 24/7, significantly increasing the number of Isle of Man patients who can receive this treatment within the required time window. Patients who have received treatment at The Walton Centre and need ongoing care may transition to LUFHT for continued support.
Respiratory Services Respiratory clinics: Diagnosis and management of respiratory conditions.
Critical Care Services Intensive care units (ICUs): Critical care for patients with life-threatening conditions. High-dependency units (HDUs): Intermediate level of care for patients requiring close monitoring.
Diagnostic Imaging Services X-ray, CT scan, MRI, PET CT, ultrasound: Imaging services for diagnostic purposes. Interventional radiology: Minimally invasive procedures guided by imaging techniques.
Pathology Services Laboratory testing: Analysis of blood, tissue, and other specimens for diagnostic purposes. Provision of technical oversight and clinical advice, including professional judgement of individual cases, for Haematology laboratory activities. Histopathology: Examination of tissue samples for pathological analysis.
Dental Services (The Liverpool University Dental Hospital) General dentistry: Routine dental care and preventive services. Specialty clinics: Specialized dental services such as orthodontics, oral surgery, and periodontics.
Cancer Services Oncology clinics: Diagnosis, treatment, and management of cancer. Chemotherapy and radiotherapy: Cancer treatment modalities. Palliative care: Supportive care for patients with advanced cancer.
Cardiology Services Cardiac clinics: Diagnosis and treatment of heart conditions. Cardiac catheterization lab: Interventional procedures for heart conditions.
Renal Services Nephrology clinics: Diagnosis and treatment of kidney disorders.
Renal dialysis: Haemodialysis and peritoneal dialysis services.
Service Requirements
Prior Approval Response Time Standard See SC29.21 Within [ ] Operational Days following the date of request Or Not applicable
GOVERNANCE AND REGULATORY
Provider’s Nominated Individual See SC1.4
Provider’s 2018 Act Responsible Person See SC3.17 N/A
Commissioners’ UEC DoS Leads See SC6.18
Provider’s UEC DoS Contact See SC6.18
Provider’s Health Inequalities Lead (NHS Trusts and NHS Foundation Trusts only) See SC13.8
Provider’s Net Zero Lead (NHS Trusts and NHS Foundation Trusts only) See SC18.2
Provider’s Infection Prevention Lead See SC21.1
Provider’s Accountable Emergency Officer See SC30.1
Provider’s Child Sexual Abuse and Exploitation Lead See SC32.2
Provider’s Mental Capacity and Liberty Protection Safeguards Lead See SC32.2
Provider’s Prevent Lead See SC32.2
Provider’s Safeguarding Lead (adults) / named professional for safeguarding adults See SC32.2
Provider’s Safeguarding Lead (children) / named professional for safeguarding children See SC32.2
Provider’s Controlled Drugs Accountable Officer (NHS Trusts, NHS Foundation Trusts and English Independent Hospitals only) See SC33.12
Provider’s Wellbeing Guardian (NHS Trusts and NHS Foundation Trusts only) See GC5.9
Provider’s Freedom To Speak Up Guardian(s) See GC5.10
Provider’s Caldicott Guardian See GC21.3
Provider’s Data Protection Officer (if required by Data Protection Legislation) See GC21.3
Provider’s Information Governance Lead See GC21.3
Provider’s Senior Information Risk Owner See GC21.3
CONTRACT MANAGEMENT
Addresses for service of Notices See GC36 Commissioner: Manx Care Noble’s Hospital Estate, Strang, Braddan IM4 4RJ Email: Provider: Liverpool University Hospitals NHS Foundation Trust Prescot Street Liverpool Merseyside L7 8XP Email:
Frequency of Review Meetings See GC8.1 Monthly, but will be reviewed during the Contract Term to a frequency not greater than Quarterly.
Commissioner Representative(s) See GC10.3
Provider Representative See GC10.3
Nominated Mediation Body (where required – see GC14.4) CEDR
Date Document Description
Diagnostics available on-island.docx Outlines the diagnostic and investigative services available on the Isle of Man. It serves to inform UK providers about what can be conducted locally in the Isle of Man, reducing the need for patients to travel off- island.
Service name Elective and Non elective services (as listed in the Service Categories)
Service specification number N/A
Population and/or geography to be served Residents of the Isle of Man
Service aims and desired outcomes The Provider shall deliver tertiary and acute healthcare services to Isle of Man patients with access and clinical outcomes equivalent to those available to UK residents accessing the Provider’s services. The aims include: Ensuring timely, high-quality, and equitable healthcare provision. Supporting a close working relationship with the Commissioner’s (Manx Care) clinicians, including clear and inclusive arrangements for Multi-Disciplinary Teams (MDTs). Optimising patient care through efficient use of on-island and off-island resources, reducing unnecessary travel and follow- up appointments where possible.
Service description and location(s) from which it will be delivered The Provider shall deliver a range of elective and non-elective services, primarily at its site(s) in Liverpool, with some services delivered partly on the Isle of Man (e.g., via visiting clinics, virtual consultations, or local delivery by the Commissioner (Manx Care) with Provider support). The list of services below is indicative and may be personalised based on individual patient needs. Services include: Accident & Emergency (A&E) Services Emergency medical care for patients with acute illnesses, injuries, or medical emergencies. Medical Services Including but not limited to: General medicine: Diagnosis, treatment, and management of various medical conditions. Specialty clinics: Specialized clinics for specific medical conditions, such as diabetes, hypertension, and infectious diseases. Surgical Services Including but not limited to: General surgery: Surgical procedures for common surgical conditions. Orthopaedic surgery: Treatment for musculoskeletal injuries and conditions.
Row Labels Sum of Activity Plan Sum of Activity Actual Sum of Price Plan Sum of Price Actual
AKI IP UNBUNDLED 2 0 357 0 ARD 7 2 1,429 262 ARMD DRUGS 0 0 323,845 375,631 ARMD FULL 922 1,111 952,300 1,147,891 ARMDASSESS 337 220 166,699 109,035 ARMDTREAT 358 318 326,973 290,578 AUDIOLOGY 5 3 0 0 CONTRACT ADJUSTMENT PHASING 0 0 0 0 DC 408 422 572,277 569,053 DI 332 320 55,352 47,952 DIRECT ACCESS 0 7 0 216 DIRECT ACCESS DEXA/NUCLEAR MEDICINE 65 59 45,209 21,804 DIRECT ACCESS RADIOLOGY 115 240 93,461 193,419 EL 261 244 1,503,526 1,443,737 ELXBD 56 171 18,634 55,654 EXCDRUGSIP 0 0 125,067 98,503 EXCDRUGSOP 0 0 379,791 492,723 EXCLUDED DEVICES 0 0 204,989 215,827 EXCLUDED DRUGS HOMECARE 0 0 232,905 210,706 EXCLUDED ITEM 0 0 11,703 10,201 H&N 0 0 24,576 0 HAEMOPHILIA BLOOD PRODUCTS 0 0 52,014 38,644 HDU 340 291 315,622 270,533 ITU 187 84 399,882 180,108 LIMBS & WHEELCHAIRS 0 0 10,916 10,916 NEL 17 21 169,891 276,629 NELNE 22 69 265,060 823,480 NELNEXBD 0 15 0 5,176 NELST 2 0 1,773 0 NELXBD 42 0 20,424 0 OPFAMPCL 15 25 6,382 8,005 OPFANFTF 178 112 45,368 26,417 OPFASPCL 781 579 172,805 120,908 OPFUPMPCL 24 71 6,024 14,355 OPFUPNFTF 930 905 136,913 128,374 OPFUPSPCL 2,771 2,098 246,668 193,121 OPPROC 1 0 310 0 OPPROCFA 273 376 61,817 64,293 OPPROCFUP 1,261 1,856 192,327 291,261 OTHER 0 0 5,890 5,890 PDT 5 0 5,657 0 PDT DRUGS 0 0 3,105 0 RENAL HDU 27 5 25,064 4,774 RENAL TRANSPLANTS 3 0 120,445 0 SPC IP UNBUNDLED 77 96 6,020 7,535 STSFCE 2 0 4,322 0 TELESTROKE SERVICE 0 0 93,044 93,044 TOTAL PARENTERAL NUTRITION 0 0 29,139 42,161 TRAUMA BP 0 0 34,010 43,884 (blank)
Grand Total 9,822 9,723 7,469,984 7,932,697
Section/Clause 2025/26 NHS Manx Care Adjustment Rationale
Standard
Contract
SC1.1 Deliver Services in accordance with NHS England’s national priorities Replace with Manx Care Operating Plan https://www.manx.news/wp- content/uploads/2025/03/Manx- Care-Operating-Plan.pdf IOM uses own health strategy; 24/25 referenced NHS Long Term Plan
SC3.1.1 – 3.1.2 Elective activity recovery (52- week waits, diagnostics within 6 weeks) Optional; applies only if specified in Service Specifications for off-island services Assess relevance to IOM off-island scope; not mandatory
SC6.1, SC6.10 Right to Choice, NHS Constitution, elective pathways, digital referrals Exception - Choice to realign with Manx Care policies which don’t include patient choice; digital referrals retained IOM lacks NHS Constitution; tailor choice to IOM pathways (i.e. restricted choice)
SC6.10 Digital referral systems (e.g., e-Referral Service) Per IOM locally agreed referral pathways SC6.10 new in 25/26; IOM and its patients currently do not use NHS e-Referral
SC18.1–SC18.4 NHS Choice Framework Exception - Choice to realign with Manx Care policies which don’t include patient choice; digital referrals retained IOM lacks NHS Constitution and Service User legal rights to Choice; tailor choice to IOM pathways (i.e. restricted choice)
SC33 PSIRF replaces NRLS PSIRF reporting to Manx Care’s system: DatixEnquiries@gov.im 24/25 used NRLS; PSIRF new in 25/26; align with local reporting
SC36.1, SC36.4 Fixed Payment for The Commissioner (Manx Care) shall make monthly payments to the Provider IOM commissions differently than
Trusts, API adjustments based on the actual activity delivered in the respective month, as determined by the Activity Reporting submitted by the Provider. Payments will reflect the NHS Tariff unit costs (or Local tariff pricing agreed with the provider) for the services provided, as outlined in the contract schedule. On a quarterly basis, the Provider may issue a reconciliation invoice or credit note to adjust the monthly payments where necessary to the agreed actual activity levels, as verified through the Activity Reporting process. ICB given our unique situation in the region
GC5.1- GC5.8 Staff; ICB oversight Not applicable NHS/NHS E policy, not relevant to IOM as Commissioner
GC10.1–GC10.3 Co-ordinating Commissioner role Manx Care as sole Commissioner IOM is a single- commissioner model; IOM has not appointed a appointed a Co-ordinating Commissioner, hence IOM as single Commissioner applies throughout GC and SC.
GC21.1–GC21.23 Confidentiality, Data Security Toolkit, DPIAs, cyber resilience Retain 2025/26 IG standards however, reference is made to IoM Data Protection Legislation; IOM aligns with UK GDPR but uses its own local laws
Quality Requirement Threshold Method of measurement Period over which the requirement is to be achieved Applicable Service Specification
1 Insert text and/or attach spreadsheet or documents locally in respect of one or more Contract Years or state Not Applicable
2
3
4
5
Date Document
Insert text locally or state Not Applicable
Date Document
Sub-Contractor Service Description Start date/expiry date Processing If the Sub-Contractor is processing
Personal Data – Personal Data, state whether the Sub-
[Name]
Yes/No Contractor is a Data Processor OR a
[Registered Office] Data Controller OR a joint Data
Controller
[Company number]
Insert text locally or state Not Applicable
Co-ordinating Role/Responsibility
Commissioner/Commissioner
Manx Care Reviews, on an annual basis, changes to the UK’s NHS National Standard Contract Particulars, Service Conditions and General Conditions so that the Contract between Manx Care and the Provider may be updated to align with those changes (e.g. new standards); and if Manx Care and the Provider cannot agree to applying those NHS changes to Manx Care’s contract with the Provider, then the default would be the NHS National Standard Terms.
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
National Requirements Reported Centrally
1 As specified in the Schedule of Approved Collections published at https://digital.nhs.uk/isce/publication/nhs- standard-contract-approved-collections where mandated for and as applicable to the Provider and the Services As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
1a Without prejudice to 1 above, daily submissions of timely Emergency Care Data Sets, in accordance with DAPB0092-2062 and with detailed requirements published at https://digital.nhs.uk/data-and- information/data-collections-and-data-sets/data- sets/emergency-care-data-set-ecds/ecds-latest-update As set out in relevant Guidance As set out in relevant Guidance Daily A+E, U
2 Patient Reported Outcome Measures (PROMS) https://digital.nhs.uk/data-and-information/data-tools- and-services/data-services/patient-reported-outcome- measures-proms As set out in relevant Guidance As set out in relevant Guidance As set out in relevant Guidance All
National Requirements Reported Locally
1a Activity and Finance Report Monthly In the format specified in the relevant Information Standards Notice (DCB2050) [For local agreement] A, MH
1b Activity and Finance Report Monthly [For local agreement] [For local agreement] All except A, MH
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
2 Service Quality Performance Report, detailing performance against National Quality Requirements, Local Quality Requirements and the duty of candour, including, without limitation: Monthly As per that agreed with the Trust’s main commissioner Within 15 Operational Days of the end of the month to which it relates
2a details of any thresholds that have been breached and breaches in respect of the duty of candour that have occurred; All
2b details of all requirements satisfied; All
2c details of, and reasons for, any failure to meet requirements All
3 Where CQUIN applies, CQUIN Performance Report and details of progress towards satisfying any CQUIN Indicators, including details of all CQUIN Indicators satisfied or not satisfied [For local agreement] [For local agreement] [For local agreement] All
4 Complaints monitoring report, setting out numbers of [For local agreement] In accordance with ICB agreed format. [For local agreement] All
complaints received and including analysis of key
themes in content of complaints
5 Report against performance of Service Development In accordance with relevant SDIP In accordance with relevant SDIP In accordance with relevant SDIP All
and Improvement Plan (SDIP)
6 Summary report setting out relevant information on Monthly [For local agreement] In accordance with ICB agreed format. [For local agreement] All
Patient Safety Incidents and the progress of and
outcomes from Patient Safety Investigations, as
agreed with the Co-ordinating Commissioner
7 Data Quality Improvement Plan: report of progress In accordance with relevant DQIP In accordance with relevant DQIP In accordance with relevant DQIP All
against milestones
8 Report on outcome of reviews and evaluations in relation to Staff numbers and skill mix in accordance with GC5.2 (Staff) Annually (or more frequently if and as required by the Co- ordinating [For local agreement] Not Applicable [For local agreement] Not Applicable All
Reporting Period Format of Report Timing and Method Service
for delivery of Report category
Commissioner from time to time)
9 Where the Services include Specialised Services and/or other services directly commissioned by NHS England (or commissioned by an ICB, where NHS England has delegated the function of commissioning those services), specific reports as set out at https://www.england.nhs.uk/nhs-standard-contract/dc- reporting/ (where not otherwise required to be submitted as a national requirement reported centrally or locally) As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ As set out at https://www.england.n hs.uk/nhs-standard- contract/dc-reporting/ And Reports to be sent to: All
10 Report on progress against Green Plan in accordance with SC18.2 (NHS Trust/FT only) Annually [For local agreement] [For local agreement] All
Local Requirements Reported Locally
1 Monthly See attached details in Schedule 6 for PTL and SLAM format requirement The Provider must submit any patient- identifiable data required in relation to Local Requirements Reported Locally via the Data Landing Portal in accordance with the Data Landing Portal Acceptable Use Statement. [Otherwise, for local agreement] Reports to be sent to: In accordance to SUS timetable All
SLAMs and PLDS and any other associated patient
tracking activity and performance reports related to
Manx Care’s patients under the care of the Provider.
Data Quality Indicator Data Quality Threshold Method of Measurement Milestone Date
1 Delete the italicised guidance notes above; insert text locally or state Not Applicable
2
3
4
Milestones Timescales Expected Benefit
# Data Element Format and Length Population Guidance Notes Mandatory (M), Mandatory Where Relevant (R) or Optional (O)
1 FINANCIAL MONTH max an2 1=April, 2= May, 3 June….12=March, with no leading zeros. The month in which the census occurred. M
2 FINANCIAL YEAR an6 202425=2024/25, 202526=2025/26 etc. The slash (/) symbol must not be included. The financial year in which the census occurred. M
3 DATE AND TIME DATA SET CREATED an19 DD-MM-CCYY- hh:mm:ss Valid date and time format - as shown in the Specification. The date and time that the file was created prior to its submission. This timestamp will be used to ascertain the latest version of the submission. M
4 ORGANISATION IDENTIFIER (CODE OF PROVIDER) min an3 max an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. NHS Providers must complete this data element with their valid national 3-character Trust code with no trailing zeros (i.e. RNA not RNA00). M
5 SITE CODE (OF TREATMENT) min an5 max an9 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The ORGANISATION SITE CODE of the ORGANISATION where the PATIENT was treated. M
6 ORGANISATION IDENTIFIER (CODE OF COMMISSIONER) min an3 max an5 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The derived commissioner as derived with reference to the NHS England Commissioner Assignment Method (CAM), where possible given that the exact treatment may not be known in advance, and hierarchy for assigning NHS England directly-commissioned services. M
7 GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION) an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. National ODS code - see the NHS Digital ODS Portal for valid codes. M
8 WITHHELD IDENTITY REASON an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. To be populated where any of the patient identifiable fields are not provided due to withheld identity reasons. Where the TREATMENT FUNCTION CODE indicates activity relating to a sensitive data item e.g. HIV or G- U Medicine no patient identifiable fields should be populated and the appropriate WITHHELD IDENTITY REASON code used. R
9 NHS NUMBER n10 If the NHS NUMBER does not exist the LOCAL PATIENT IDENTIFIER (EXTENDED) must be populated. The population of this data element is not required where the WITHHELD IDENTITY REASON is populated. R
10 LOCAL PATIENT IDENTIFIER (EXTENDED) max an20 R
11 MAIN SPECIALTY CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
12 TREATMENT FUNCTION CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
13 SOURCE OF REFERRAL (FOR OUTPATIENTS) n2 Valid code - see the NHS Data Model and Dictionary website for valid codes. The source of referral of each Consultant Out-Patient Episode. M
14 REFERRER CODE an8 Valid code - see the NHS Data Model and Dictionary website for valid codes. The code of the PERSON making the REFERRAL REQUEST. M
15 PRIORITY TYPE (REFERRAL) n1 Valid code - see the NHS Data Model and Dictionary website for valid codes. The priority of the service request (referral). M
16 REFERRAL TO TREATMENT PERIOD START DATE an10 CCYY-MM-DD M
17 REFERRAL TO TREATMENT PERIOD STATUS an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. RTT status is defined as ‘the status of an activity (or anticipated activity) for the RTT period, decided by the lead care professional’ or in other words: • whether each activity is part of an RTT pathway or not; • whether the activity has started an RTT clock, stopped an RTT clock or continued an existing ticking RTT clock. M
18 REFERRAL TO PROFESSIONAL CATEGORY n1 1 = Consultant Led 2 = Nurse Led 3 = Allied Health Professional Led M
19 WAITING LIST TYPE n1 1 = Out-Patient Waiting List (First Appointment) 2 = Out-patient Waiting List (Follow Up Appointment) 3 = Elective Admission List (Daycase) 4 = Elective Admission List (Inpatient) 5 = Diagnostic List 6 = Transplant List M
20 NEXT ACTIVITY 1 = O/P Waiting List - Booked. 2 = O/P Waiting List - Not Booked. 3 = Awaiting Diagnostic - Booked. 4 = Awaiting Diagnostic - Booked - Isle of Man Team. 5 = Awaiting Diagnostic - Not Booked. 6 = Admitted Waiting List - No TCI Date 7 = Admitted Waiting List - TCI Date Offered. 8 = Watchful Wait review R
21 NEXT ACTIVITY DATE an10 DD-MM-CCYY M
22 OUT-PATIENT APPOINTMENT BOOKED DATE an10 DD-MM-CCYY R
23 TO COME IN (TCI) DATE an10 DD-MM-CCYY The TCI date is a formal offer in writing of a date of admission. R
24 INTENDED MANAGEMENT CODE an1 Valid code - see the NHS Data Model and Dictionary website for valid codes. May not be needed as Point of Delivery can be determined from WAITING LIST TYPE M
25 PLANNED PROCEDURE CODE an5 Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The intended surgical procedure of those patients with a Decision to Treat, as defined by the Office of Population Censuses and Surveys (OPCS). procedure codes R
26 PLANNED PROCEDURE DESCRIPTION min an3 max an125 Text description of Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The corresponding text description of the PLANNED PROCEDURE CODE. R
27 WAITING LIST PRIORITY (P CODE) min an1 max an2 1a = Emergency - operation needed within 24 hours 1b = Urgent - operation needed with 72 hours 2 = Surgery that can be deferred for up to 4 weeks 3 = Surgery that can be delayed for up to 3 months 4 = Surgery that can be delayed for more than 3 months Surgical priority group of the patient. R
Patient Level Contract Monitoring Data Set (CDS) Specification ht tps://www.datadictionary.nhs.uk/data_sets/supporting_data_sets/patient_level_contract_monitoring_data_set.html
SUBMISSION HEADER
To carry the submission header details.One occurrence of this group is required.
ID Mandation Data Elements
1 M FINANCIAL MONTH
2 M FINANCIAL YEAR
3 M DATE AND TIME DATA SET CREATED
4 M REPORTING TYPE INDICATOR
ORGANISATION DETAILS
To carry the Organisation details of the Provider and Commissioner.One occurrence of this group is required.
ID Mandation Data Elements
5 M ORGANISATION IDENTIFIER (CODE OF PROVIDER)
6 R ORGANISATION SITE IDENTIFIER (OF TREATMENT)
7 M ORGANISATION IDENTIFIER (GP PRACTICE RESPONSIBILITY)
8 R ORGANISATION IDENTIFIER (RESIDENCE RESPONSIBILITY)
9 M ORGANISATION IDENTIFIER (CODE OF COMMISSIONER)
10 M GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
DEMOGRAPHICS
To carry the demographic details of the patient.One occurrence of this group is required.
ID Mandation Data Elements
11 R WITHHELD IDENTITY REASON
12 R NHS NUMBER
13 R LOCAL PATIENT IDENTIFIER (EXTENDED)
14 R POSTCODE OF USUAL ADDRESS
15 R PERSON BIRTH DATE
16 R AGE AT ACTIVITY DATE (CONTRACT MONITORING)
17 R PERSON STATED GENDER CODE
18 R ETHNIC CATEGORY
CARE ACTIVITY DETAILS
To carry the care activity details.One occurrence of this group is permitted.
ID Mandation Data Elements
19 R CDS UNIQUE IDENTIFIER
20 R NON CDS UNIQUE IDENTIFIER
21 R ACTIVITY TREATMENT FUNCTION CODE
22 O LOCAL SUB-SPECIALTY CODE
23 R HOSPITAL PROVIDER SPELL IDENTIFIER
24 R OUTPATIENT ATTENDANCE IDENTIFIER
25 R EMERGENCY CARE ATTENDANCE IDENTIFIER
26 R ACTIVITY START DATE (CONTRACT MONITORING)
27 R ACTIVITY END DATE (CONTRACT MONITORING)
28 R ADJUSTED LENGTH OF STAY
29 R PACKAGE OF CARE OR YEAR OF CARE START DATE (CONTRACT MONITORING)
30 M UNBUNDLED EPISODE INDICATOR
31 R LOCAL TREATMENT CATEGORY CODE
32 R LOCAL TREATMENT CODE
33 O LOCATION OF ACTIVITY START
34 O LOCATION OF ACTIVITY END
SERVICE AGREEMENT AND COMMISSIONING DETAILS
To carry the service agreement and commissioning details.One occurrence of this group is required.
ID Mandation Data Elements
35 R PROVIDER REFERENCE NUMBER
36 R NHS SERVICE AGREEMENT LINE NUMBER
37 M COMMISSIONED SERVICE CATEGORY CODE
38 R SERVICE CODE
39 M POINT OF DELIVERY CODE
40 R POINT OF DELIVERY FURTHER DETAIL CODE
41 R POINT OF DELIVERY FURTHER DETAIL DESCRIPTION
42 O LOCAL POINT OF DELIVERY CODE
43 O LOCAL POINT OF DELIVERY DESCRIPTION
44 O LOCAL CONTRACT CODE
45 O LOCAL CONTRACT MONITORING CODE
46 O LOCAL CONTRACT MONITORING DESCRIPTION
47 O CONTRACT MONITORING ADDITIONAL DETAIL (FIRST)
48 O CONTRACT MONITORING ADDITIONAL DESCRIPTION (FIRST)
COST AND PRICING DETAILS
To carry the activity and costing details.One occurrence of this group is required.
ID Mandation Data Elements
49 R TARIFF CODE
50 M NATIONAL TARIFF INDICATOR
51 M ACTIVITY COUNT (POINT OF DELIVERY)
52 M ACTIVITY UNIT PRICE
53 M TOTAL COST
Mandation M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) cannot be completed without this data element being present. R = Required: NHS business processes cannot be delivered without this data element. O = Optional: the inclusion of this data element is optional as required for local purposes.
Type of Survey Frequency Method of Reporting Method of Publication
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
National Quarterly Pulse Survey (NQPS) (if the Provider is an NHS Trust or an NHS Foundation Trust) As required by NQPS Guidance As required by NQPS Guidance As required by NQPS Guidance
Staff Survey (appropriate NHS staff surveys where required by Staff Survey Guidance) [Other] [Insert further description locally] As required by Staff Survey Guidance As required by Staff Survey Guidance As required by Staff Survey Guidance
[Other insert locally (for example, Service User Survey, Carer Survey]
Description Details
Commissioner for which Data Processing Services are to be performed Manx Care
Subject matter of the processing Provision of specialized acute and tertiary services, including elective and non-elective cases for referred by Manx Care / Isle of Man
Duration of the processing 1 April 2025 until Contract end date.
Nature and purposes of the processing The processing involves the collection, recording, organisation, and provision of specialized healthcare services for patients referred by Manx Care. The purposes include medical treatment, diagnostics, patient care management, and maintaining health records in accordance with statutory obligations.
Type of Personal Data Patient information, including but not limited to: name, address, date of birth, medical history, diagnostic data, treatment plans, and any other relevant medical information necessary for the provision of healthcare services
Categories of Data Subject Patients (and their guardians) referred by Manx Care for specialized healthcare services.
Plan for return and destruction of the data once the processing is complete UNLESS requirement under law to preserve that type of data Data will be retained for the duration of the treatment and for a period minimum of 8 years after the conclusion of treatment or 25 years in the case of records relating to the treatment of children. Upon completion of the processing, the data will be securely returned to the Commissioner or destroyed in accordance with applicable data protection laws and regulations. If there is a legal requirement to preserve certain types of data, the Provider will notify the Commissioner and specify the reasons for the extended retention period.
Manx Care
Noble's Hospital Estate
Strang
Braddan
IM4 4RJ
Scope This Service Level Agreement (“SLA”) covers out of hours stroke consultant on call advice service using telemedicine for stroke patients requiring thrombolysis between: - Noble’s Hospital (“the Commissioner”) at Strang Rd, Braddan, Isle of Man IM4 4RJ, Isle of Man and - Liverpool University Hospitals NHS Foundation Trust (LUHFT) (“the Provider”) at Aintree University Hospital (AUH), Lower Lane, Fazakerley, Liverpool, L9 7AL
Term This SLA will operate with effect from 1st April 2024 (“Effective Date”) for 24 months. The end date of the SLA being 31st March 2027.
Summary Finance Model
Finance The detailed costs of this SLA are set out in Section 9 below: The total annual charge for this SLA is £57,701.60. Out of Hours Covers: • Monday to Friday- 17:00-09:00 • Saturday, Sunday and Bank Holiday- 24 hours, inclusive of the two additional IOM bank holidays per year. • The SLA includes provision for post-procedure care for 10 thrombectomy patients, detailing an additional per patient charge if required. • The SLA includes provision of 1 PA per quarter of Consultant Governance Lead time for governance purposes.
Summary Services Specification (“the Services”)
The aim of the service is for The provision of a consultant-led out of hour’s telemedicine service for the assessment of patients presenting with acute stroke who may be eligible to receive thrombolysis or thrombectomy within the Isle of Man to (“The Commissioner”)
The purpose of its provision is to achieve Support the delivery of a safe out of hours stroke care by the specialist team at LUHFT to (“the Commissioner”)
Scope and Description of the Service
What? The purpose of this service is for the provision of a consultant-led out of hour’s telemedicine service for the assessment of patients presenting with acute stroke who may be eligible to receive thrombolysis or thrombectomy within the Isle of Man.
Post procedure(thrombectomy) care of patient which would include (to be funded, initially, on a possible 10 patient plus a cost per person cost): • Transfer from Walton to HASU bed in Aintree • Time period up to 24 hours (patients will wait for air transfer to IOM) • This would be level 2 care with appropriate medical (Stroke consultant and resident doctor) nursing, therapy cover with access to MET teams/ Critical care should there be deterioration. Quarterly governance meeting with IOM stroke team: This will require 1 PA of consultant (LUHFT stroke governance lead) time every 3 months.
Where (“Agreed Premises”) Provided remotely via telemedicine and telephone
By / From whom (“the Provider”) The on call out of hours stroke consultant at LUHFT will provide advice and guidance and proscribe treatment
On what days / dates etc. Out of Hours Covers: • Monday to Friday- 17:00-09:00 • Saturday, Sunday and Bank Holiday- 24 hours, including the additional IOM bank holidays
Key personnel All LUHFT Stroke Consultants who participate on the on-call rota
Commissioner Provider
Operational
Clinical
Finance
Other specific issues The aim of this Service Level Agreement is to ensure compliance with resilient compliance procedures and monitoring mechanisms that will assist management in their duty of care. Furthermore, outline continuity of communication to enable delivery of a comprehensive, efficient, professional and cost-effective Service aimed at meeting the requirement of all staff, clients and visitors to Hospital, whilst eliminating or reducing risks. • Need for AI for CT perfusion interpretation at IOM site – via Brainomix • Explore IOM stroke nurse shadowing/training at Aintree site – funded via education fund and additional to SLA.
Summary Operational Model
Process and Pathways
For non-clinical services incl. info re key contacts, day to day management etc.
For clinical services include referral information.
Applicable Quality and Safety Standards
In line with NICE Clinical Guideline 68, the service is to provide: • A stroke physician who is trained and experienced in the management of acute stroke via an on-call telemedicine service • An assessment of the patient by the stroke physician using agreed network documentation, protocols and policies • Videoconferencing and remote access to CT head images to allow the stroke physician to decide whether the patient should receive thrombolysis therapy • A stroke physician who will link with local staff who are trained in delivering thrombolysis and in the monitoring for any complications associated with thrombolysis. Recipients of the service are adults aged 16 years or older who present to an emergency department on the Isle of Man and are identified as potentially having a stroke via a validated stroke assessment tool (Recognition Of Stroke In the Emergency Room and National Institute Health Stroke Scale). Eligible patients will have presented within eligible treatment delivery time frames and meet the set criteria for stroke treatment (thrombectomy / thrombolysis).
Accountability, Responsibility & Governance
Governance is the framework of accountability to users, stakeholders and the wider community, within which organisations take decisions and lead and control their functions, to achieve their objectives (Audit Commission 2003). The service provider, in collaboration with the Department will ensure effective governance arrangements are implemented for the Tele stroke service. The role of the provider for the Tele stroke service in relation to governance will be: • To hold responsibility for managing indemnity for: • Decision to refer for thrombectomy/ thrombolysis • Maintenance and safety of their technology • To ensure that the identified Medical Director of the tele stroke network acts in collaboration with the Departments Medical Director on the Isle of Man. • To facilitate mechanisms for appraisal and feedback for stroke physicians working on the Tele stroke rota, and to identify to the Isle of Man if there are any performance concerns • To act in accordance with any instruction/s of the Isle of Man Caldecott Guardian • Ensure quality is delivered by achievement of agreed standards. • Ensure appropriately trained staff as per core standards are available within own site • To fully engage in the investigation and action of any patient safety incidents involving Tele stroke, in collaboration with the Department • To organise the stroke physician rota • To have responsibility for the maintenance and replacement of their equipment
Performance Management
The service provider must be aware of the provisions for handling performance and conduct concerns of doctors in the NHS. The service provider will be required to facilitate feedback for stroke physicians working on the Tele stroke rota, and inform the Department if there are any performance concerns. The clinicians within the stroke physician rota will be expected to provide feedback on the Department telemedicine team and highlight any performance concerns to the clinical lead. Both parties commit to timely exchange of information such as invoicing and data relating to this service. Performance monitoring will align with the above-mentioned service provision and (where appropriate) through the staff member’s appraisals, 1-2-1s and other performance management undertaken by LUHFT.
Review
This SLA is subject to annual review and reaffirmation by signature.
Resolution
Any matters requiring resolution in the event or queries arising from the detail of this SLA will be managed with reference to clause 9 of the attached Conditions.
BETWEEN: (The “Commissioner”)
AND (The “Provider”)
Together referred to as the “Parties” or individually a “Party”.
Term This Agreement will commence on 1st April 2024 for an initial period of 24 months or until terminated by either party in accordance with clause 10 of the Conditions (“the Term”).
Services The Services to be provided by the Provider to the Commissioner shall be as set out in Section 1 (“the Services”)
Entire Agreement. This Agreement comprises I. Service Level Agreement Overview [Section 1 of this document] II. This signature page [Section 2 of this document] III. The attached Conditions [Section 3 of this document] IV. Nominated Officers [Section 4 of this document] V. Change Control Process [Sections 5 & 6 of this document] VI. Documents relied on [Section 7 of this document] VII. Service Specification Model (Section 8 of this document) VIII. Finance Model (Section 9 of this document)
Signed on behalf of the Commissioner Signed on behalf of the Provider
Name: Name:
Title: Title:
Organisation: Organisation: Liverpool University Hospitals Group
Date: Date: 05.03.2026
Nominated representative of the Commissioner Nominated representative of the Provider
Signed: Signed:
Name: Name:
Title: Title:
Address: Address: University Hospitals of Liverpool Group Aintree Hospital Lower Lane Liverpool L9 7AL
Tel No:
Email: Email:
Document SLA Teams Site
Location
Date Issued Author
07/02/2025
Revision Date Brief Summary of Changes Changes
Marked
07/02/2025 Draft created based on past SLA contents & update from HoOp/ Finance Team on what is currently being delivered.
CV Ref: Commissioner: Provider: Date:
Service:
Basis of Contract Variation: Funding:
Commencement date of CV: Duration: Profile:
Activity Details
Current Year: Recurrent Full Year Effect:
Finance Details
Current Year: Recurrent Full Year Effect:
Operational Changes
Current Year: Recurrent Full Year Effect:
Authorisation
Authorised by : On behalf of Liverpool University Hospitals NHS Foundation Trust (“the Provider”) On behalf of the Commissioner Confirmation of activity/operational changes: Contracting Dept Confirmation of funding available: Finance Dept
Scope This Service Level Agreement (“SLA”) covers the Provision of Ophthalmology Out of Hours On-Call Support between: - Manx Care (“the Commissioner”) at Noble’s Hospital, Strang Rd, Braddan, Isle of Man IM4 4RJ, Isle of Man and - Liverpool University Hospitals NHS Foundation Trust] (“the Provider”) at Royal Liverpool University Hospital, Prescot Street, Liverpool, Merseyside, L7 8XP
Term This SLA will operate with effect from 1st April 2026 (“Effective Date”) for 3 years. The end date of the SLA being 31st March 2029. The Parties may agree to extend the Term by a further period of up to two (2) years by giving not less than six (6) months’ prior written notice before the end of the initial Term. Any such extension must be confirmed in writing and signed by both Parties.
Summary Finance Model
Finance The detailed costs of this SLA are set out in Section 9 below: The total annual charge for this SLA is £45,000 The commissioner will pay a sum of £30,000 per annum for the provision of this service along with an additional payment of £15,000 per annum which will be ring fenced by the provider to pay for educational training of those ophthalmology doctors providing the on-call support.
Summary Services Specification Model (“the Services”)
The aim of the service is to Provide an Ophthalmology Out of Hours On-Call to (“The Commissioner”)
The purpose of its provision is to achieve Support the delivery Ophthalmology Out of Hours On- Call to (“the Commissioner”) through provision of Programmed Activities (PAs)
Scope and Description of the Service
What? This SLA covers the provision of out-of-hours virtual ophthalmology support by LUHFT’s St Paul’s Eye Unit to Manx Care. The service includes: • Second on-call support (08:00–20:00) on weekends and bank holidays for Manx Care ophthalmology doctors. • On-call advice (20:00–08:00) 7 days a week for Manx Care Emergency Department doctors.
Support is provided remotely, with referral decisions made jointly using agreed clinical pathways. A Data Sharing Agreement will support the secure exchange of clinical images to aid decision-making.
Where (“Agreed Premises”) The service is delivered virtually from the St Paul’s Eye Unit, Royal Liverpool University Hospital, to Manx Care clinicians on the Isle of Man, with patient transfers arranged as needed via established air ambulance protocols.
By / From whom (“the Provider”) Liverpool University Hospitals NHS Foundation Trust (LUHFT), St Paul’s Eye Unit at the Royal Liverpool University Hospital
On what days / dates etc Every night (20:00–08:00), 365 days per year, for Emergency Department support Every weekend day and Isle of Man bank holiday (08:00–20:00), for second on-call support to non- Consultant ophthalmology doctors
Key personnel Commissioner Provider
Operational
Clinical xx
Finance xx
Other Specific issues Not applicable.
Summary Operational Model
Process and Pathways
For non-clinical services incl. info re key contacts, day to day management etc. Day-to-day service delivery will be coordinated by the Clinical Lead from Manx Care Ophthalmology, with contractual oversight managed by the Surgical Care Group. LUHFT will provide quarterly activity reports, and any service-related issues or process changes will be jointly managed and communicated by the appropriate contacts from both organisations.
For clinical services include referral information. Referrals to LUHFT’s on-call Ophthalmology service are made by Manx Care ophthalmology or Emergency Department clinicians, following the Emergency Eye Care Referral Pathway. Contact is made via the LUHFT switchboard, and referrals may include image sharing (supported by a Data Sharing Agreement). Where appropriate, patients may be transferred off- island to St Paul’s Eye Unit via air ambulance, in line with existing procedures.
Applicable Quality and Safety Standards
Royal College of Ophthalmologists (RCOphth) Standards for Urgent & Emergency Eye Care The service must comply with RCOphth guidance for urgent and emergency secondary ophthalmic care, including: • Maintaining robust, reliable clinical and administrative arrangements between the advising unit and the receiving/remote hospital to ensure timely and efficient referral, escalation, and transfer pathways. • Ensuring access to and use of approved emergency ophthalmic protocols for high-risk presentations (acute glaucoma, endophthalmitis, orbital haemorrhage, CRAO, etc.). • Operating a formally recognised 24/7 urgent and emergency care plan, covering patients presenting locally, transferred from other hospitals, or already admitted with new eye problems.
Patient-Centred Standards  Rapid access for emergencies.  Avoid delays or mis-triage.  Effective communication with local clinicians.
Accountability, Responsibility & Governance
• Day-to-day service management will be the responsibility of the allocated professional from Manx Care’s Ophthalmology Service. • Contractual management will be undertaken by the allocated professional from Manx Care’s Surgical Care Group, in liaison with LUHFT. • LUHFT will provide a quarterly report detailing the number, date, time, and nature of on-call episodes within 15 working days of each quarter end. • The service will be reviewed annually by both parties. • In the event of a dispute, escalation will be made to the Chief Executive Officer of Manx Care and a LUHFT representative.
Performance Management
Both parties commit to timely exchange of information such as invoicing and data relating to this service. Performance monitoring will align with the above-mentioned service provision and through the staff member’s appraisals, 1-2-1s and other performance management undertaken by LUHFT. For more details, please refer to Section 3 ‘Attached Condition’ sub-section 4 ‘Performance Monitoring and Quality of Service’.
Review
This SLA is subject to annual review and reaffirmation by signature.
Resolution
Any matters requiring resolution in the event or queries arising from the detail of this SLA will be managed with reference to clause 9 of the attached Conditions.
BETWEEN: (The “Commissioner”)
AND (The “Provider”)
Together referred to as the “Parties” or individually a “Party”.
Term This Agreement will commence on 1st April 2026 for an initial period of [3 years or until terminated by either party in accordance with clause 10 of the Conditions (“the Term”). The Parties may agree to extend the Term by up to a further two (2) years by giving not less than six (6) months’ prior written notice before the end of the initial Term. Any such extension must be agreed in writing and signed by both Parties.
Services The Services to be provided by the Provider to the Commissioner shall be as set out in Section 1 (“the Services”)
Entire Agreement. This Agreement comprises I. Service Level Agreement Overview [Section 1 of this document] II. This signature page [Section 2 of this document] III. The attached Conditions [Section 3 of this document] IV. Nominated Officers [Section 4 of this document] V. Change Control Process [Sections 5 & 6 of this document] VI. Documents relied on [Section 7 of this document] VII. Service Specification Model (Section 8 of this document) VIII. Finance Model (Section 9 of this document) if applicable.
Signed on behalf of the Commissioner Signed on behalf of the Provider
Name: Name:
Title: Title:
Organisation: Manx Care Organisation:
Date: Date:
Nominated representative of the Commissioner Nominated representative of the Provider
Signed: Signed:
Name: Name:
Title: Title:
Address: Address:
Tel No: Tel No:
Email: Email:
Document SLA Teams Site
Location
Date Issued Author
July 2025 Strategy & Planning Office
Revision Date Brief Summary of Changes Changes
Marked
July 2025 SLA V2 moved onto new SLA template
Feb 26 Reviewed and updated by Manx Care
CV Ref: Commissioner: Provider: Date:
Service:
Basis of Contract Variation: Funding:
Commencement date of CV: Duration: Profile:
Activity Details
Current Year: Recurrent Full Year Effect:
Finance Details
Current Year: Recurrent Full Year Effect:
Operational Changes
Current Year: Recurrent Full Year Effect:
Authorisation
Authorised by : On behalf of Liverpool University Hospitals NHS Foundation Trust (“the Provider”) On behalf of the Commissioner Confirmation of activity/operational changes: Contracting Dept Confirmation of funding available: Finance Dept
· Pathology
1) Biochemistry:
Albumin
Alkaline Phosphatase
Amylase
Bilirubin
Calcium (total and ionized)
Cholesterol (Total and HDL)
Creatinine
Glucose
HbA1c (Glycosylated Hemoglobin)
LDH (Lactate Dehydrogenase)
Lipid Profile
Magnesium
Potassium
Sodium
Total Protein
Triglycerides
Urea
2) Haematology:
Full Blood Count (FBC)
Blood Film Analysis
Coagulation Screen (including INR/APTT Ratio)
D-Dimer Testing
Reticulocyte Counts
Malaria Screen
Plasma Viscosity
3) Immunology:
Immunoglobulins (IgG, IgA, IgM)
Rheumatoid Factor
Thyroid Peroxidase Antibodies
Microbiology:
Glandular Fever Screen
MRSA Screening
Urine Culture and Sensitivity
Blood Cultures
Stool Pathogen Testing
4) Serology:
•H Ieslpea otfi tMis aSnc r •e e InMin4 g4 RJ
mHaIVn xTceasrtei.nimg (Urgent Testing Available)
Rubella Antibodies
· Cardiology 1) ECG: Standard 12 lead 24/48/72 hour 7 day 14 day 2) Echocardiography: Transthoracic Bubble/Contrast Ambulatory Monitoring: Blood Pressure (ABP) 3) Exercise Tolerance Testing: Treadmill ETT Pacemaker/CRT-P: In-office Follow-up Remote Follow-up 4) CRT-D/ICD - In-Office Follow Up 5) Implantable Loop Recorder: In- Office and Remote Follow Up
· Respiratory
1) Lung Function Tests:
Flow Volume Loop
DLCO
Body Plethysmography
Nitrogen Washout
FeNO
Impulse Oscillometry
Bronchodilator Reversibility
Earlobe Capillary Blood Gas
2) Exercise and Challenge Tests:
Six-minute Walk Test
Mannitol Challenge Test
Sleep Apnoea Diagnostics:
Overnight Oximetry
Polygraphy
TOSCA
Fixed Pressure CPAP
Autoset CPAP
Face-to-Face Follow-up
Remote Follow-up
3) N on-Invasive Ventilation:
NIV
ASV
Fac up e-to-Face and Remote Follow-
· Cardiology
1) ECG:
Standard 12 lead
24/48/72 hour
7 day
14 day
2) Echocardiography:
Transthoracic
Bubble/Contrast
Ambulatory Monitoring:
Blood Pressure (ABP)
3) Exercise Tolerance Testing:
Treadmill ETT
Pacemaker/CRT-P:
In-office Follow-up
Remote Follow-up
4) CRT-D/ICD - In-Office Follow Up
5) Implantable Loop Recorder: In- Office and Remote Follow Up
· Radiology
CT
MRI
Ultrasound
Fluroscopy
Image Guide d Procedures
Mammograp hy and Breast Screening
X-ray
Bone Densitometry
Dental Imaging
# Data Element Format and Length Population Guidance Notes Mandatory (M), Mandatory Where Relevant (R) or Optional (O)
1 FINANCIAL MONTH max an2 1=April, 2= May, 3 June….12=March, with no leading zeros. The month in which the census occurred. M
2 FINANCIAL YEAR an6 202425=2024/25, 202526=2025/26 etc. The slash (/) symbol must not be included. The financial year in which the census occurred. M
3 DATE AND TIME DATA SET CREATED an19 DD-MM-CCYY- hh:mm:ss Valid date and time format - as shown in the Specification. The date and time that the file was created prior to its submission. This timestamp will be used to ascertain the latest version of the submission. M
4 ORGANISATION IDENTIFIER (CODE OF PROVIDER) min an3 max an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. NHS Providers must complete this data element with their valid national 3-character Trust code with no trailing zeros (i.e. RNA not RNA00). M
5 SITE CODE (OF TREATMENT) min an5 max an9 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The ORGANISATION SITE CODE of the ORGANISATION where the PATIENT was treated. M
6 ORGANISATION IDENTIFIER (CODE OF COMMISSIONER) min an3 max an5 Valid ODS code – see the NHS Digital ODS Portal for valid codes. The derived commissioner as derived with reference to the NHS England Commissioner Assignment Method (CAM), where possible given that the exact treatment may not be known in advance, and hierarchy for assigning NHS England directly-commissioned services. M
7 GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION) an6 Valid ODS code – see the NHS Digital ODS Portal for valid codes. National ODS code - see the NHS Digital ODS Portal for valid codes. M
8 WITHHELD IDENTITY REASON an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. To be populated where any of the patient identifiable fields are not provided due to withheld identity reasons. Where the TREATMENT FUNCTION CODE indicates activity relating to a sensitive data item e.g. HIV or G- U Medicine no patient identifiable fields should be populated and the appropriate WITHHELD IDENTITY REASON code used. R
9 NHS NUMBER n10 If the NHS NUMBER does not exist the LOCAL PATIENT IDENTIFIER (EXTENDED) must be populated. The population of this data element is not required where the WITHHELD IDENTITY REASON is populated. R
10 LOCAL PATIENT IDENTIFIER (EXTENDED) max an20 R
11 MAIN SPECIALTY CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
12 TREATMENT FUNCTION CODE an3 Valid code - see the NHS Data Model and Dictionary website for valid codes. M
13 SOURCE OF REFERRAL (FOR OUTPATIENTS) n2 Valid code - see the NHS Data Model and Dictionary website for valid codes. The source of referral of each Consultant Out-Patient Episode. M
14 REFERRER CODE an8 Valid code - see the NHS Data Model and Dictionary website for valid codes. The code of the PERSON making the REFERRAL REQUEST. M
15 PRIORITY TYPE (REFERRAL) n1 Valid code - see the NHS Data Model and Dictionary website for valid codes. The priority of the service request (referral). M
16 REFERRAL TO TREATMENT PERIOD START DATE an10 CCYY-MM-DD M
17 REFERRAL TO TREATMENT PERIOD STATUS an2 Valid code - see the NHS Data Model and Dictionary website for valid codes. RTT status is defined as ‘the status of an activity (or anticipated activity) for the RTT period, decided by the lead care professional’ or in other words: • whether each activity is part of an RTT pathway or not; • whether the activity has started an RTT clock, stopped an RTT clock or continued an existing ticking RTT clock. M
18 REFERRAL TO PROFESSIONAL CATEGORY n1 1 = Consultant Led 2 = Nurse Led 3 = Allied Health Professional Led M
19 WAITING LIST TYPE n1 1 = Out-Patient Waiting List (First Appointment) 2 = Out-patient Waiting List (Follow Up Appointment) 3 = Elective Admission List (Daycase) 4 = Elective Admission List (Inpatient) 5 = Diagnostic List 6 = Transplant List M
20 NEXT ACTIVITY 1 = O/P Waiting List - Booked. 2 = O/P Waiting List - Not Booked. 3 = Awaiting Diagnostic - Booked. 4 = Awaiting Diagnostic - Booked - Isle of Man Team. 5 = Awaiting Diagnostic - Not Booked. 6 = Admitted Waiting List - No TCI Date 7 = Admitted Waiting List - TCI Date Offered. 8 = Watchful Wait review R
21 NEXT ACTIVITY DATE an10 DD-MM-CCYY M
22 OUT-PATIENT APPOINTMENT BOOKED DATE an10 DD-MM-CCYY R
23 TO COME IN (TCI) DATE an10 DD-MM-CCYY The TCI date is a formal offer in writing of a date of admission. R
24 INTENDED MANAGEMENT CODE an1 Valid code - see the NHS Data Model and Dictionary website for valid codes. May not be needed as Point of Delivery can be determined from WAITING LIST TYPE M
25 PLANNED PROCEDURE CODE an5 Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The intended surgical procedure of those patients with a Decision to Treat, as defined by the Office of Population Censuses and Surveys (OPCS). procedure codes R
26 PLANNED PROCEDURE DESCRIPTION min an3 max an125 Text description of Valid OPCS code - see theThe NHS Classifications Browser for valid codes. The corresponding text description of the PLANNED PROCEDURE CODE. R
27 WAITING LIST PRIORITY (P CODE) min an1 max an2 1a = Emergency - operation needed within 24 hours 1b = Urgent - operation needed with 72 hours 2 = Surgery that can be deferred for up to 4 weeks 3 = Surgery that can be delayed for up to 3 months 4 = Surgery that can be delayed for more than 3 months Surgical priority group of the patient. R
Patient Level Contract Monitoring Data Set (CDS) Specification https://www.datadictionary.nhs.uk/data_sets/supporting_data_sets/patient_level_contract_monitoring_data_set.html
SUBMISSION HEADER
To carry the submission header details.One occurrence of this group is required.
ID Mandation Data Elements
1 M FINANCIAL MONTH
2 M FINANCIAL YEAR
3 M DATE AND TIME DATA SET CREATED
4 M REPORTING TYPE INDICATOR
ORGANISATION DETAILS
To carry the Organisation details of the Provider and Commissioner.One occurrence of this group is required.
ID Mandation Data Elements
5 M ORGANISATION IDENTIFIER (CODE OF PROVIDER)
6 R ORGANISATION SITE IDENTIFIER (OF TREATMENT)
7 M ORGANISATION IDENTIFIER (GP PRACTICE RESPONSIBILITY)
8 R ORGANISATION IDENTIFIER (RESIDENCE RESPONSIBILITY)
9 M ORGANISATION IDENTIFIER (CODE OF COMMISSIONER)
10 M GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
DEMOGRAPHICS
To carry the demographic details of the patient.One occurrence of this group is required.
ID Mandation Data Elements
11 R WITHHELD IDENTITY REASON
12 R NHS NUMBER
13 R LOCAL PATIENT IDENTIFIER (EXTENDED)
14 R POSTCODE OF USUAL ADDRESS
15 R PERSON BIRTH DATE
16 R AGE AT ACTIVITY DATE (CONTRACT MONITORING)
17 R PERSON STATED GENDER CODE
18 R ETHNIC CATEGORY
CARE ACTIVITY DETAILS
To carry the care activity details.One occurrence of this group is permitted.
ID Mandation Data Elements
19 R CDS UNIQUE IDENTIFIER
20 R NON CDS UNIQUE IDENTIFIER
21 R ACTIVITY TREATMENT FUNCTION CODE
22 O LOCAL SUB-SPECIALTY CODE
23 R HOSPITAL PROVIDER SPELL IDENTIFIER
24 R OUTPATIENT ATTENDANCE IDENTIFIER
25 R EMERGENCY CARE ATTENDANCE IDENTIFIER
26 R ACTIVITY START DATE (CONTRACT MONITORING)
27 R ACTIVITY END DATE (CONTRACT MONITORING)
28 R ADJUSTED LENGTH OF STAY
29 R PACKAGE OF CARE OR YEAR OF CARE START DATE (CONTRACT MONITORING)
30 M UNBUNDLED EPISODE INDICATOR
31 R LOCAL TREATMENT CATEGORY CODE
32 R LOCAL TREATMENT CODE
33 O LOCATION OF ACTIVITY START
34 O LOCATION OF ACTIVITY END
SERVICE AGREEMENT AND COMMISSIONING DETAILS
To carry the service agreement and commissioning details.One occurrence of this group is required.
ID Mandation Data Elements
35 R PROVIDER REFERENCE NUMBER
36 R NHS SERVICE AGREEMENT LINE NUMBER
37 M COMMISSIONED SERVICE CATEGORY CODE
38 R SERVICE CODE
39 M POINT OF DELIVERY CODE
40 R POINT OF DELIVERY FURTHER DETAIL CODE
41 R POINT OF DELIVERY FURTHER DETAIL DESCRIPTION
42 O LOCAL POINT OF DELIVERY CODE
43 O LOCAL POINT OF DELIVERY DESCRIPTION
44 O LOCAL CONTRACT CODE
45 O LOCAL CONTRACT MONITORING CODE
46 O LOCAL CONTRACT MONITORING DESCRIPTION
47 O CONTRACT MONITORING ADDITIONAL DETAIL (FIRST)
48 O CONTRACT MONITORING ADDITIONAL DESCRIPTION (FIRST)
COST AND PRICING DETAILS
To carry the activity and costing details.One occurrence of this group is required.
ID Mandation Data Elements
49 R TARIFF CODE
50 M NATIONAL TARIFF INDICATOR
51 M ACTIVITY COUNT (POINT OF DELIVERY)
52 M ACTIVITY UNIT PRICE
53 M TOTAL COST
Mrea n •d a Ntioonble’s Hospital • Strang • Braddan • Isle of Man • IM4 4RJ M = Mandatory: this data element is mandatory and the technical process (e.g. submission of the data set, production of output etc) c a +nn4o4t (b0e) c o1m62pl4e t6ed5 0w0it0ho0u t t h is dat a eelnemquenirti beesi@ng mpreasnexnct.are.im R = Required: NHS business processes cannot be delivered without this data element. www.manxcare.im O = Optional: the inclusion of this data element is optional as required for local purposes.

Full Response Text

1/56 | Particulars

Manx Care Off-Island Commissioning Contract

Particulars

Contract title & ref:
Clatterbridge Cancer Centre Services to the Isle of Man
Ref: 1707

Version 1, April 2023

Classification: Official IOM Publication reference:
Manx Care Off-Island Commissioning Contract

2/56 | Particulars

Contract Reference

1707

DATE OF CONTRACT

1 April 2023

SERVICE COMMENCEMENT DATE

1 April 2023

CONTRACT TERM

The initial term of this agreement shall be three (3) years, commencing on 1 April 2023 and concluding on 31 March 2026.

Upon expiration of the initial term, the parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C

COMMISSIONERS

Manx Care (a statutory board of the Isle of Man Government) Noble’s Hospitals Estate Strang Braddan Isle of Man IM4 4RJ

PROVIDER

Clatterbridge Cancer Centre NHS Foundation Trust Clatterbridge Road Bebington Wirral CH63 4JY

ODS: REN

Manx Care Off-Island Commissioning Contract

3/56 | Particulars CONTENTS

PARTICULARS

CONTENTS ....................................................................................................... SCHEDULE 1 – SERVICE COMMENCEMENT ................................................ A. Conditions Precedent............................................................................ B. Commissioner Documents .................................................................... C. Extension of Contract Term .................................................................. SCHEDULE 2 – THE SERVICES ...................................................................... A. Service Specifications ........................................................................... Ai. Service Specifications – Enhanced Health in Care Homes ................... Aii. Service Specifications – Primary and Community Mental Health Services.......................................................................................................... B. Indicative Activity Plan .......................................................................... C. Activity Planning Assumptions .............................................................. D. Essential Services (NHS Trusts only) ................................................... E. Essential Services Continuity Plan (NHS Trusts only) .......................... F. Clinical Networks .................................................................................. G. Other Local Agreements, Policies and Procedures .............................. H. Transition Arrangements ....................................................................... I. Exit Arrangements ................................................................................ J. Transfer of and Discharge from Care Protocols .................................... K. Safeguarding Policies and Mental Capacity Act Policies ...................... L. Provisions Applicable to Primary Medical Services .............................. M. Development Plan for Personalised Care ............................................. N. Health Inequalities Action Plan ............................................................. SCHEDULE 3 – PAYMENT ............................................................................... A. Aligned Payment and Incentive Rules .................................................. B. Locally Agreed Adjustments to NHS Payment Scheme Unit Prices ..... C. Local Prices .......................................................................................... D. Expected Annual Contract Values ........................................................ E. Timing and Amounts of Payments in First and/or Final Contract Year . F. CQUIN .................................................................................................. SCHEDULE 4 – LOCAL QUALITY REQUIREMENTS ....................................... SCHEDULE 5 – GOVERNANCE ....................................................................... A. Documents Relied On ........................................................................... B. Provider’s Material Sub-Contracts ........................................................ Manx Care Off-Island Commissioning Contract

4/56 | Particulars C. Commissioner Roles and Responsibilities ............................................ SCHEDULE 6 – CONTRACT MANAGEMENT, REPORTING AND INFORMATION REQUIREMENTS .................................................................... A. Reporting Requirements ....................................................................... B. Data Quality Improvement Plans .......................................................... C. Service Development and Improvement Plans ..................................... D. Surveys ................................................................................................. E. Data Processing Services ..................................................................... SCHEDULE 7 – PENSIONS ..............................................................................

Manx Care Off-Island Commissioning Contract

5/56 | 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 Choice and Referral SC7 Withholding and/or Discontinuation of Service SC8 Unmet Needs, Making Every Contact Count and Self Care SC9 Consent SC10 Personalised Care 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 Urgent Access to Mental Health Care SC16 Complaints SC17 Services Environment and Equipment SC18 Green NHS and Sustainability SC19 National Standards for Healthcare Food and Drink SC20 Service Development and Improvement Plan SC21 Infection Prevention and Control and Staff Vaccination SC22 Assessment and Treatment for Acute Illness SC23 Service User Health Records SC24 NHS Counter-Fraud Requirements SC25 Other Local Agreements, Policies and Procedures 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 Children and Adults SC33 Patient Safety SC34 End of Life Care SC35 Duty of Candour SC36 Payment Terms SC37 Local Quality Requirements SC38 CQUIN SC39 Procurement of Goods and Services

Annex A National Quality Requirements Annex B Provider Data Processing Agreement

Manx Care Off-Island Commissioning Contract

6/56 | Particulars 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 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 Gifts 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

Definitions and Interpretation

11/04/24 Director of Finance 05/06/24 Manx Care Off-Island Commissioning Contract

8/56 | Particulars

SERVICE COMMENCEMENT AND CONTRACT TERM

Effective Date

See GC2.1

1 April 2023 Expected Service Commencement Date

See GC3.1

1 April 2023 Longstop Date

See GC4.1 and 17.10.1

Contract Term The initial term of this agreement shall be three (3) years, commencing on 1 April 2023 and concluding on 31 March 2026.

The parties may mutually agree to extend the contract up to 24 months in accordance with Schedule 1C

Commissioner option to extend Contract Term

See Schedule 1C, which applies only if YES is indicated here

YES

By 24 months Commissioner Notice Period (for termination under GC17.2) 24 months
[Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here] Commissioner Earliest Termination Date (for termination under GC17.2) 12 months after the Service Commencement Date
[Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here] Provider Notice Period (for termination under GC17.3) 24 months
[Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]
Provider Earliest Termination Date (for termination under GC17.3) 12 months after the Service Commencement Date
[Period(s) as agreed/determined locally in respect of the Contract as a whole and/or specific Services – to be specified here]

Manx Care Off-Island Commissioning Contract

9/56 | Particulars SERVICES Service Categories Indicate all categories of service which the Provider is commissioned to provide under this Contract. Note that certain provisions of the Service Conditions and Annex A to the Service Conditions apply in respect of some service categories but not others. Medical Oncology: Diagnosis, treatment, and management of cancer using chemotherapy, targeted therapy, immunotherapy, and hormonal therapy. Radiation Oncology Administration of radiation therapy to target and destroy cancer cells while minimizing damage to healthy tissue. Surgical Oncology Surgical procedures to remove tumours and cancerous tissue, often as part of the primary treatment or to alleviate symptoms. Support Services Counselling, nutritional support, pain management, physical therapy, and other supportive services to address the physical, emotional, and practical needs of cancer patients. Multidisciplinary Care Collaboration among oncologists, surgeons, radiation oncologists, nurses, and other specialists to develop individualized treatment plans tailored to each patient's needs. Radiology and Imaging Diagnostic imaging services such as MRI, CT scans, PET scans, and ultrasound to aid in cancer diagnosis and treatment planning. Pathology Examination and analysis of tissue samples and body fluids to diagnose cancer and determine its characteristics, such as type, stage, and grade. Genetic Counselling Evaluation of genetic risk factors for cancer and counselling for individuals and families regarding hereditary cancer syndromes and genetic testing options. Patient Education and Outreach Educational programs, support groups, and resources for patients and their families to enhance understanding of cancer, treatment options, and coping strategies. Survivorship Programs Follow-up care and support for cancer survivors, including monitoring for recurrence, managing late effects of treatment, and promoting overall wellness. This list may not be exhaustive, and the specific services offered by Clatterbridge Cancer Centre may vary and personalised as required for each respective patient.

Service Requirements Prior Approval Response Time Standard

See SC29.25

Not applicable Manx Care Off-Island Commissioning Contract

10/56 | Particulars GOVERNANCE AND REGULATORY Nominated Mediation Body (where required – see GC14.4) CEDR Provider’s Nominated Individual

Provider’s Information Governance Lead

Provider’s Data Protection Officer (if required by Data Protection Legislation)

Provider’s Caldicott Guardian

Provider’s Senior Information Risk Owner

Provider’s Accountable Emergency Officer

Provider’s Safeguarding Lead (children) / named professional for safeguarding children

Provider’s Safeguarding Lead (adults) / named professional for safeguarding adults

Provider’s Child Sexual Abuse and Exploitation Lead

Provider’s Mental Capacity and Liberty Protection Safeguards Lead

Provider’s Prevent Lead

Provider’s Freedom To Speak Up Guardian(s)

Provider’s UEC DoS Contact [ ] Email: [ ] Tel: [ ] Commissioners’ UEC DoS Leads

Not Applicable Provider’s Infection Prevention Lead

Provider’s Health Inequalities Lead

Provider’s Net Zero Lead

Manx Care Off-Island Commissioning Contract

11/56 | Particulars

Provider’s 2018 Act Responsible Person Not Applicable Provider’s Wellbeing Guardian (NHS Trusts and Foundation Trusts only)

CONTRACT MANAGEMENT Addresses for service of Notices

See GC36 Commissioner:

Manx Care Noble’s Hospital Estate,
Strang, Braddan IM4 4RJ
Email: Commissioningandcontracts.ManxCare@gov.im

Provider:

Clatterbridge Cancer Centre NHS Foundation Trust Clatterbridge Road Bebington Wirral CH63 4JY

Email: [ ] Frequency of Review Meetings

See GC8.1

Initially Monthly but will be reviewed during the term of this Agreement to a frequency not greater than Quarterly

Commissioner Representative(s)

See GC10.3

Provider Representative

See GC10.3

Manx Care Off-Island Commissioning Contract

12/56 | Particulars SCHEDULE 1 – SERVICE COMMENCEMENT AND CONTRACT TERM

A. Conditions Precedent

The Provider must provide the Commissioner with the following documents:

  1. Evidence of appropriate Indemnity Arrangements

  2. Evidence of CQC registration of the Provider

  3. Evidence of the CQC Registration in respect of any Material Sub-Contractors (where required)

  4. Evidence of the Provider Licence in respect of Provider and Material Sub- Contractors (where required)

  5. List of Material Sub-Contracts, Commissioner at the Service Commencement date and annual

[Response truncated — full text is 860,121 characters]