Here's a new acronym for you, the snappily-titled 'Framework for Procuring External Support for Co...
Here's a new acronym for you, the snappily-titled 'Framework for Procuring External Support for Commissioners' (FESC) - an initiative launched by the Department of Health to see if the private sector can help primary care trusts (PCTs) with their role in commissioning services, for example, from NHS trusts. Some 14 private sector companies were chosen and Hillingdon PCT has already asked Bupa to look at managing its contracts with acute hospitals.
It will be important to identify where the potential added value is and this is made more difficult because insurers and PCTs are not used to working together in the UK. Most of the initiatives so far seem to be drawn from the US and UK private medical insurance sector, but other collaborations could be developed with the UK long-term insurance sector. Accurate risk assessment is an aspiration for PCTs and a cash reality for insurers and reinsurers. Also, insurers are moving away from application forms and GP reports and have begun to use tele-interviews and tests at pharmacies or private networks.
In a separate development, the Department of Health has also announced personal budgets for those eligible for publicly funded adult social care and Lord Darzi's recent NHS report suggested that personal budgets for people with long-term conditions could include NHS res-ources. In this new world, health and social care providers will support a group of people determined by consumer choice but with a budget indirectly provided by a PCT and a local authority. This could provide further opportunities for insurers to hold the risks of such a provider. It is easy to imagine a situation where a company provides disease mana-gement services to part of a PCT population on condition that it can reduce the costs of disease management. In the event of non-delivery, the PCT may prefer to transfer its exposure to risk to an insurer.
2008 promises new opportunities for brokers and insurers in managing financial flows and risk. The impression I got at the NHS Alliance conference in November was that PCT commissioners and insurers and pharmaceutical companies were keen to explore how NHS commissioning could be improved but there was little understanding about what they actually want help with and ditto among the private sector about what they could usefully offer. As these new initiatives start to take off, there are opportunities for specialist brokers to move into this market. Indeed, with public money at stake, expert advice to get best value for money looks pretty compelling.
Richard Walsh is managing director of SPPR Consulting
