London's workforce

Contracting

Overview

To address the need for a more flexible education commissioning process, work has been undertaken by the Education Commissioning Team with internal and external stakeholder input, to equip education providers with more clearly defined roles and responsibilities and greater transparency of outcomes.

Education in healthcare is complex and requires the combined efforts of both academic and clinical practitioners. The framework establishes a linear relationship between the education commissioner and the lead education provider with greater clarity on accountability and responsibility for delivering quality outcomes; it also requires agreements between Higher Education Institutions (HEIs) and NHS Service Providers to formalise their relationship with each other regarding the provision of placements.

A number of standard contractual forms have been or are being developed to support the commissioning of non-medical education services. These cover both Pre-Registration and Continuing Personal and Professional Development (CPPD) training and include:

London Education Contract (LEC) and LEC for Continuing Professional and Personal Development (LCPPD)
Learning and Development Agreement (LDA)
Customised Contracts

Standard Placement Agreements have also been produced to assist HEIs and Trusts, though the actual form of agreement is a matter for the two parties.

Improvements so far

LEC and LCPPD

To facilitate NHS London's ability to commission non-medical education services, after formal and collaborative engagement with appropriate stakeholders, two sets of standard contracts have been developed. Commissioning of Pre-Registration will be covered by the new London Education Contract (LEC), while the CPPD will be commissioned through the LEC for Continuing Professional and Personal Development (LCPPD). These contracts will be between NHS London and all Higher Education Institutions (HEIs) and Trusts as Education Providers (TEPs) who provide education services and replace the previous disparate range of contractual forms.

The LEC and LCPPD deliver a number of benefits:

consistent contract terms and conditions across London
greater flexibility for NHS London to commission services based on quality rather than historical relationships
contractual vehicles through which to administer the Quality Assurance framework.

Key differences in the characteristics of the LEC and LCPPD are as follows:

the LEC includes information on Practice Placements, including an example Placement Agreement; the LCPPD will not cover Practice Placements
LEC funding will be based on Benchmark Pricing of Education Services, and this will be outlined in the contract; LCPPD funding will be based on the Unit Prices of the individually commissioned Education Services
LEC has now been launched and signed by a significant proportion of HEIs.

You can find a copy of the LEC here on our website. Please note that the tables, dates and names are illustrative only would be personalised as appropriate.

For further information about the LEC, please get in touch with the Education Commissioning Team via education@london.nhs.uk or your designated Contract Manager.

LDA

The Learning and Development Agreement (LDA) is a formal, standardised contract between NHS London and Trusts (including Foundation Trusts) which covers all funding and resources passing from NHS London to Trusts in the areas of Workforce and Education. It is an evolutionary and time limited contractual vehicle through which:

NHS London confirms its investment
both organisations confirm their mutual roles, responsibilities and accountabilities with regard to London's learning and development agenda
governance structures put in place confirm the value of the investment.

The initial focus has been on capturing the requirements of, and funding for, NMET. The objective being to replace existing NMET Service Level Agreements and provide transparency within these funding flows to ensure clarity around the services and products which are funded. This means providing a standard contract to reflect existing, rather than impose any additional, obligations.

The first iteration of the LDA forms the basis on which to develop any future obligations for performance improvement and quality assurance, as well as the inclusion of Medical and Dental professions.

Customised Contracts

While the LEC and LCPPD are intended to cover the commissioning of most non-medical education, there will always be exceptional circumstances which will require customised contractual forms. The purpose of this area of work has been to define specific criteria to ensure that customisation of contracts, and use of specialised contractual forms, is limited to specifically defined circumstances.

A clear decision making process has been developed in order to determine which contractual form is appropriate for the services being commissioned. It outlines the criteria which each set of services must meet in order to be suitable for each type of Standard Contract. Only in situations where these criteria are not met should the production of a customised contract be considered, and in these cases the majority of the clauses and schedules from the Standard Contracts may still be applicable. Discussions with stakeholders have been held around the contractual service criteria to be included, based on the possible scenarios which NHS London may encounter. These include, among others, areas where education services are delivered alongside others, such as administration services.

Future changes being planned

LCPPD

Further refinement of the contracts will be undertaken prior to the negotiation of CPPD contracts that will then be used for CPPD commissioning rounds.

LDA

NHS London intends to develop a single LDA which incorporates the Medical and Dental professions and the Non - medical professions. To accomplish this there is a need for a fit/gap analysis between the current LDA and the existing SIFT and MADEL Funding flow agreements. Amendments will be made to the main body of the LDA, and additional schedules added to the agreement to cover Medical and Dental funding. To ensure this a comprehensive and inclusive contract, a reference group will be initiated which will enable us to 'temperature check the agreement prior to negotiation, and also ensure that the contract meets the obligations outlined by medical regulatory bodies such as the PMETB. There will also be further engagement with Trusts and other Healthcare Services Bodies (HSBs) as we further develop the Foundational LDA into quality assured and performance managed contract.

NHS London will work closely with the London Deanery to develop the SIFT and MADEL areas of the LDA. If you would like to find out more about the Contracting work, please contact the Education Commissioning Team at education@london.nhs.uk.