NHS South Yorkshire ICB Sheffield Place : Musculo-Skeletal (MSK) Service

The Authority is of the view that it is in the best interest of Sheffield residents to make a direct award of contract to Sheffield Teaching Hospitals NHS Foundation Trust for a further 18 months for three reasons:<br/><br/>• The South Yorkshire Integrated Care System continues to go through a period of significant transition as a direct consequence of Covid-19 and due to legislation changes in the National Health Service<br/><br/>• A service change during this period is very likely to destabilise the current provider organisation and have significant negative impact on Elective Recovery<br/><br/>• The prolonged impact of Covid 19 and subsequent service recovery efforts have prevented adequate collection of the Outcomes Data required to enable a thorough assessment of the service model.<br/><br/>Further rationale supporting these points:<br/><br/>Transition<br/><br/>On 1st July 2022 the original contracting Authority, NHS Sheffield CCG, ceased to exist and was replaced with NHS South Yorkshire ICB. All CCG responsibilities and liabilities were transferred to the new organisation, including the Sheffield MSK Service. The ICB will continue to operate as four places, each with a funding allocation and a strategy to meet the needs of the local people. However, the legislative changes have a significant impact on how decisions are made, including stronger partnership working across the system. As the decision-making structures are in development, the Authority feels it is not appropriate to make a decision on the future MSK model until these structures are in place. <br/>Under COVID-19 Directives the MSK contract, and the main contract for acute and community services with Sheffield Teaching Hospitals, were not in place for the 20/21 and 21/22 financial years. STH were paid a nationally mandated monthly block payment which was based on 19/20 income levels and therefore included the budget for MSK. Local contracts were reinstated from 1st April 2022, however in line with national guidance for 22/23 the South Yorkshire ICB has agreed an Aligned Payment and Incentive (API) contract with the Trust which, like the previous two years, includes a non-tariff based fixed contract value that incorporates most of the activity commissioned, including the MSK service. Further work is required to understand the impact of these changes on the MSK service before the service can be reviewed.