Inspired by the success of a neighbouring trust, we supported Western Sussex Hospitals to implement the Aligned Incentive Contract – encouraging trust and respect between providers and commissioners.
Objective
Prompted by suffering relationships, dissatisfied system partners and regulators, and ongoing formal dispute resolution processes, Western Sussex Hospitals sought help to develop an alternative approach to contract management.
The new approach needed to foster relationships built on trust and respect, thus enabling delivery of better services and outcomes.
What we did
We supported Western Sussex Hospitals to adopt an approach called the Aligned Incentive Contract, taking learnings from their neighbours Portsmouth Hospitals NHS Trust, already successfully using the approach.
Enshrined in the contract is the principle of ‘we will think well of each other’, encouraging the culture change necessary to avoid antagonistic behaviours or perceived game playing, foster relationships built on trust, and facilitate finding solutions together within a constrained budget. We also worked to change ingrained views about historic assertive transactional contract management and the National Tariff.
The new Aligned Incentive Contract encourages organisations to shift from focusing on transactions to innovation, and a move away from simply counting an activity to rewarding impact.
Enshrined in the contract is the principle of ‘we will think well of each other’, encouraging the culture change necessary to avoid antagonistic behaviours or perceived game playing, foster relationships built on trust, and facilitate finding solutions together within a constrained budget. We also worked to change ingrained views about historic assertive transactional contract management and the National Tariff.
The new Aligned Incentive Contract encourages organisations to shift from focusing on transactions to innovation, and a move away from simply counting an activity to rewarding impact.
Activity
Contracting and system governance
Fully tested model to forecast bed usage, discharges, and community demand.
Data driven decision making
Underpinning methodology enabled the model to be easily updated.
Outcome
- Relationships between providers and commissioners improved significantly as a result of the new contract. Organisations shared secondments and worked out of each other’s offices, building understanding between them of each other’s roles and ways of working.
- Removing this need to deal with ongoing disputes has given the trust more headroom to concentrate on operational issues. In 2016 Western Sussex Hospitals NHS Foundation Trust was rated ‘outstanding’ by the Care Quality Commission, a status that has been maintained since the move to the new contract.
- Since the launch of the Aligned Incentive Contract, Western Sussex Hospitals has joined up with Brighton and Sussex University Hospitals to form University Hospital Sussex NHS Foundation Trust. This merger was made smoother by the fact that they had adopted very similar contracts and providers were already working collaboratively.
