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Healthwatch Nottingham and Healthwatch Nottinghamshire response to announcement of Accountable Care System developer

The Sustainability and Transformation Plan (STP) for Nottingham and Nottinghamshire has been produced in response to recent NHS England planning guidance and to deliver the NHS Five Year Forward View.

Local NHS providers, clinical commissioning groups (CCGs), councils, and other health and care services have formed the Nottingham and Nottinghamshire Sustainability and Transformation Partnership – one of 44 in England – to collectively plan how local services will work to improve the quality of care, and their population’s health and manage finances across the system.

NHS England announced in June that the Nottingham and Nottinghamshire STP would become an accelerated Accountable Care System with an early focus on Greater Nottingham.

The decision to work with Capita PLC and their partner Centene UK was taken after a competitive procurement process.

Healthwatch have issued the following statement in response to this announcement.

Healthwatch recognise there are significant concerns regarding the development and implementation of the Accountable Care System (ACS), in particular, concerns shared by the public around the delivery record of Capita, and potential further privatisation of the NHS.

Healthwatch sit on the STP Advisory Group and we have raised a number of concerns directly with the STP leadership. Primarily we have highlighted that transparency, engagement and understanding of the ACS is far lower than we would hope it to be. We have also raised concerns that short-term commissioning decisions are not supportive of, and could damage progression towards, the overall aims of the STP.

We recognise there is a great deal of positive change for people in our area and for the services detailed within the local Sustainability and Transformation plan.

Going forward we will continue to be both challenging and supportive of STP Leadership team to ensure that there are effective engagement plans in place and to promote a meaningful consultation process about proposed changes to local services.

Michelle Livingston – Healthwatch Nottinghamshire, Interim Executive Chair


Dr Stephen Shortt, lead for the accountable care system in Greater Nottingham said: “Our local STP was given access to substantial transformation funding this year when Nottingham and Nottinghamshire was named as one of eight national ‘accelerator sites’ to develop accountable care systems (ACS) as a new integrated healthcare model.

“The aim of this model is to offer patients a more joined up experience of healthcare by bringing all our local providers together under one NHS and social care system. But it will take a lot of time, expertise and coordinated effort to achieve. That’s why we have invested £2.7m in 2017/18 of the national funding to buy in support from Centene UK who have international experience of helping public health systems to provide better patient outcomes.

“The role of Capita in the competitive procurement process for this contract has been misrepresented. Clinical Commissioning Groups routinely procure commissioning support via a central list of accredited providers on the NHS Lead Provider Framework. As a ‘prime provider’ on this framework, Capita plc supported the tender process and effectively acted as link between the Transformation Partnership and Centene UK.

“The Nottingham and Nottinghamshire NHS has an excellent track record of working together to deliver results, which is one of the reasons we were picked to pilot this new way of working. Going forward I am hopeful that transparency and meaningful engagement will clarify the aims of the ACS as well as allow clinicians and patients to take an active role in defining the healthcare system they want to see in the future.”