How to land any qualified provider status

The movement in the last decade towards increasing patient choice by allowing non-NHS organisations to provide services under any qualified provider contracts has been central to NHS reforms.

Our charity, Horder Healthcare, a provider of acute orthopaedic and musculoskeletal services based in Crowborough, East Sussex, is one of the organisations that has successfully made this transition.

‘Even if you are not a project manager, clear project management techniques are essential’

When we began investigating AQP status − or the Extended Choice Network, as an earlier NHS contract was known − we were a standalone hospital, the Horder Centre. Six years on, we are a multisite organisation providing services in Sussex, Surrey and Kent.

Recently we have supported another organisation in beginning its AQP journey. Our advice to other organisations wanting to make this transition is as follows:

Plan your work. Even if you are not a project manager, clear project management techniques are essential. Time constraints make it necessary to define your plans and keep the project to time, budget and scope. Even if plans are amended, clearly defined milestones, deliverables and dependencies will support you.

Have senior management sponsorship. This is essential to give the project team the authority to carry out the requirements at the necessary speed and with the necessary resources, while ensuring appropriate staff engagement.

Learn the lingo early on. The NHS is brimming with terminology that often seems to exclude those who are not already in the know. Try not to let it alienate you.

Terms differ between disciplines, but soon you will wonder how you never knew what acronyms such as PAS, CAB, IGT, SUS and PbR stand for (patient administration system, Choose and Book, information governance toolkit, secondary uses service and payment by results respectively), that N3 is the NHS IT network and that NHSmail is the secure email of choice across the NHS.

Network. This will help you most of all. Find key stakeholders and like minded people and use them to reciprocally share knowledge, frustrations and experience.

‘Try not to underestimate the IT and informatics manpower needed − it may require a costly investment but it will yield benefits in future’

We linked in early on with Connecting for Health and the NHS Sussex-wide information governance group. We also chair the recently formed Independent Healthcare Information Governance Group. If the relationships are open, they provide free and essential learning.

Sometimes networking must be purchased, including professional business consultancy. More recently support has come from the Private Healthcare Information Network, along with benchmarking against other providers in the Specialist Orthopaedic Alliance.

Put requirements into perspective. With some criteria, ask if it is relevant to implement them to the full extent being used elsewhere.

Update IT. It is likely you will need new IT kit and links. You will almost certainly need to meet the information governance requirements of the information governance toolkit to allow connection to N3. The next task is to ensure your patient administration system is compliant with Choose and Book.

‘The journey will include ups, downs, frustration and long hours. Accepting this from the outset will help to ensure success’

We found limited time to ensure this, so accepted that scoping, procurement and configuration would require long and antisocial hours. Once in place, it is essential to train staff to consistently use the system. Take not of the old adage: rubbish in, rubbish out. This needs to be avoided when reporting to commissioners.

Try not to underestimate the IT and informatics manpower needed − it may require a costly investment but it will yield benefits in future.

Anticipate return on investment. You may have to pay out for all sorts of things to start with, such as a new patient administration system, but the benefits of this will be reaped later.

Things will change. Once you sign your contract you may believe you have “cracked it” by understanding what PAS, CAB and IGT mean. Be prepared for a shock as more will quickly follow. For us, payment by results and a secondary uses service were not part of the original plan − they brought with them clinical coding, which required additional skills to ensure the correct tariff was being charged to commissioners.

With little doubt, shortly following your organisation signing its contract, other things will be introduced.

Persevere. The journey will include ups, downs, frustration and long hours. Accepting this from the outset will help to ensure success. Try approaching the project as a learning opportunity, with the conviction to believe it is possible. Allow yourself to get annoyed but have the courage to keep believing.

Embrace the change. Entering into an any qualified provider contract is a challenge. But embrace it; use it as a positive opportunity; a chance for both the organisation and the individuals in the poject team to develop and grow − and let your organisation reap the benefits.

Andrew Harvey is information manager at Horder Healthcare