Accountable Care Partnerships (ACPs) will be consortia of NHS Trusts, NHS CCGs, Local Authorities, GP federations, and private and charitable care organisations. ACPs are devices for care delivery being introduced in Sustainability and Transformation Plans (STPs). By 2021, apparently, all healthcare and social care services will be delivered by ACPs. The 44 STPs in England will collectively cut national annual care costs by £22 billion by 2021. ACPs, with 10 or 15 year fixed price contracts, will be the delivery vehicle for these cuts. The fixed prices will be determined by the ‘capitation’ method (more on this below).
At an NHS ACT briefing on 5 September 2016 I was told that in NW London there would be in total five ACPs serving specific populations of between 500,000 and one million. So let’s say one of the ACPs will serve the Primary Care needs of adults. There are around 1.6 million adults in NW London. In 2013 the annual per head healthcare budget for all patients in England was £2,350. Around 25% of that was for Primary Care. Now, taking cost cutting into consideration, let’s say the annual per head cost for ACP Primary Care for adults would be £500. So the capitated annual budget for this ACP would be £800 million. And the 10 year contract value would be £8 billion. Sadly you are unlikely to have read any of this in the latest version of the NW London STP.
The published NHS annual healthcare budget for 2016/17 for England is £107 billion. The 2016/17 social care and public health budget is £25 billion. Put these together and it comes to £132 billion. The target is to reduce that by £22 billion by 2021. So ACPs delivering all care services must have an annual contracts’ value of £110 billion. If all the ACPs are just 10 year contracts then the collective ACP contracts’ value would be £1.1 trillion.
None of these ACP arrangements has been discussed in Parliament. No Parliamentary Bill has proposed these STP /ACP mechanisms. No Act of Parliament mandates any of the STP/ACP or the astronomic use of public money to fund these ACP private partnership contracts.
Judicial Review anyone?
