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STP to consider accountable care plans after regulators intervene

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  • Nine organisations considering ACS after meeting with NHS England and NHS Improvement last month
  • Acute trust to consider next step at board meeting on Thursday

Leaders in Leicestershire will decide this month how to establish a new accountable care system after receiving a “clear message” in favour of the proposal from regulators.



The plan will be considered this month by the boards of two trusts, three clinical commissioning groups, three local councils, plus the local ambulance service provider. 

A paper to University Hospitals of Leicester Trust’s board to be considered this week will outline the first steps towards an ACS, beginning with a memorandum of understanding.

The trust board will be told “clear messages” were given by NHS England and NHS Improvement at a regional sustainability and transformation partnership meeting on 3 August about the “direction of travel” towards establishing an ACS.

“This is not about ‘whether’ an ACS but ‘when’,” the report states.

The paper, prepared by the system leadership team, said regulators had stated the current system was “too complicated for commissioners to micromanage providers through service specifications.”

If approved, the nine organisations forming Leicester, Leicestershire and Rutland STP, rated advanced by NHS England in July, could join the eight ACSs already unveiled by NHS England in June.

The paper states that if organisations move to “phase one”, a single ACS leadership team would be created with clinical and executive directors for key portfolios, collectively managing a system control total.

The three CCGs would set up a joint committee with a single commissioning team. An accountability framework would be formalised through a MoU.

Clinical and service networks would be established, bringing commissioners and providers together to agree on models, care pathways and investment jointly.

It would also build on the integration of locality teams, working with a GP federation towards multispecialty community provider or accountable care organisation models, integrating health and social care in GP hubs.

It would recognise CCGs and the two local trusts as “parties” while listing the three local authorities, the ambulance trust and social enterprise Derbyshire Health United as “partners”.

The document, entitled “Moving Towards Accountable Care in LLR”, states: “NHS England and Improvement have indicated a willingness to move to single oversight arrangements for areas working as an ACS.”

If approved by the trust on Thursday and by the other organisations later this month, phase one of the plan would last between now until March, and would include the development and approval of an MoU.

The board will be told that phase one would not commit partners to the next stage of development.


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