In this section

Procurement of outpatient services

Criteria-based commissioning

Background

The CCG has adopted a criteria-based approach to the commissioning of outpatient care.  The criteria – as listed in this document – act to inform service providers of:

  • The overall standards by which the CCG will review contracted outpatient services; and,
  • The overall standards that will inform the CCG’s process of procuring, and contracting for, outpatient services. 
  • The CCG reserves the right to amend, or to add further detail, to these criteria.  
  • The criteria shall be reviewed by the CCG on a bi-annual basis.
  • The CCG’s publishing of these criteria does not alter the need for service providers to check ‘ContractsFinder’, as this is where the CCG will advertise its open procurements.

 

Download and read our full criteria here

Overall

The overall criteria shall apply to all outpatient services.  The CCG would expect a provider to demonstrate how they can, in terms of the delivery of their proposed outpatient service:

  • Meet the NHS constitutional right of all patients to receive treatment within statutory waiting times;
  • Directly reduce the size of the 18 Week Referral to Treatment waiting list for the CCG’s registered population;  
  • Work, in partnership with the CCG, and other healthcare providers, to mitigate the growth in cost of outpatient demand;
  • Provide a comprehensiveness of outpatient and diagnostic care, with a clear distinction between what they can directly provide, from the outpatient and diagnostic care that other providers would have to provide on their behalf;
  • Meet evidence-based clinical outcomes, with a clear description of how they could achieve them;
  • Achieve clinical outcomes in an efficient manner, which minimises the number of appointments a patient experiences. This would be inclusive of a provider’s direct provision of outpatient and diagnostic care, and the care that other providers would have to provide on its behalf;
  • Provide specialist advice and guidance to primary care that offers all CCG referrers a credible alternative to outpatient referral, and supports their primary care management of patients;
  • Support patient choice by having a process in-place that informs referrers and patients of the locations of service delivery, with a clear description for each of what care is provided there.   This would be inclusive of a provider’s direct provision of outpatient and diagnostic care, and the care that other providers would have to provide on its behalf;
  • Offer patients across Wakefield and District a choice of outpatient service that is attractive for them to travel to;
  • Support, with their chosen service locations, the CCG in its statutory duties to provide equitable access of care for vulnerable groups across Wakefield and District;
  • Implement comprehensive and safe processes, subject to CCG approval, for the transfer of patients to another provider for clinically required inpatient treatment;
  • Deliver outpatient care that is inclusive of all incurred costs, including all pathology tests, diagnostic tests and discrete therapies, to achieve their stated clinical outcomes.  This may be directly, or via a proposed sub-contracting arrangement that would be subject to CCG approval;
  • Code and record service activity in accordance with national standards concerning clinical coding and data quality.  This shall include how third party checks will be used by the service provider(s) to check both clinical coding and data quality;
  • Fund, procure, implement and contract manage ICT infrastructure provision including HSCN connectivity. Compiling with NHS Digital standards where appropriate to ensure security, confidentiality, and protection of NHS digital assets and services. Provider clinical systems should be interoperable with the main GP clinical systems used in the district;
  • Deliver care in accordance with the content of the CCG’s commissioning policy and national policy with regard to Evidence Based Interventions.  

 

Download and read our full criteria here