Question to the Department of Health and Social Care:

To ask Her Majesty's Government what is the budget for accountable care organisations (1) in total, and (2) for each area in which they plan to establish them.

NHS England are developing a draft accountable care organisation (ACO) contract which could be used by local commissioners to commission a provider of integrated services. An ‘ACO’ is not a new type of legal entity, neither is it a body created under delegated legislation; instead it is a service provider that holds an ACO contract. NHS England have a power to draft terms and conditions for commissioning contracts in Regulation 17 of the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012. It is for NHS England to decide, after consultation, whether to introduce the ACO contract as a further commissioning contract.

NHS England have already announced that they will be launching a consultation on the contracting arrangements for ACOs in March 2018. No ACO contract will be awarded in the meantime. NHS England has informed the Department that if an ACO contract is introduced, it is most likely that the two areas using a contract of this type will be Dudley Clinical Commissioning Group and City of Manchester Clinical Commissioning Group.

If the contract is introduced, it will always be for local commissioners to decide how best to provide services to local patients, and this includes whether or not to establish an ACO.

Where such a decision is taken, it will be for local commissioners, using the standard terms and conditions published by NHS England, to determine the details of the ACO contract. This will include the ACO budget. NHS England has published detailed guidance on how an ACO budget may be calculated. This guidance, Whole population models of provision: Establishing integrated budgets, is attached.

Where a decision has been taken to commission an ACO, the commissioner will be responsible for the award of that contract and ensuring compliance with any relevant procurement law.

The Health Select Committee is conducting a review of ACOs and NHS England is consulting on the draft ACO contract. The Government will not bring forward legislation until the NHS England consultation has concluded.