Common use of Local Modifications Clause in Contracts

Local Modifications. For each Local Modification Agreement (as defined in the National Tariff) which applies to this Contract, copy or attach the completed submission template required by Monitor (available at: ▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇.▇▇▇.▇▇/locallydeterminedprices). For each Local Modification application granted by Monitor, copy or attach the decision notice published by Monitor. Additional locally-agreed detail may be included as necessary by attaching further documents or spreadsheets. Commissioner Expected Annual Contract Value (Where applicable, specify Expected Annual Contract Value including and excluding anticipated values of any high cost drugs, devices and procedures (as listed in the National Tariff) expected to be used in connection with the relevant Services) CB_A15 Zero tolerance MRSA >0 Review of monthly Service Quality Performance Report £10,000 in respect of each incidence in the relevant month Monthly A CB_A16 Minimise rates of Clostridium difficile [Insert Baseline Threshold identified for Provider] Review of monthly Service Quality Performance Report As set out in Section B Part 8.5, in accordance with applicable Guidance Annual A CB_S6 Zero tolerance RTT waits over 52 weeks for incomplete pathways >0 Review of monthly Service Quality Performance Report £5,000 per Service User with an incomplete RTT pathway waiting over 52 weeks at the end of the relevant month Monthly Services to which 18 Weeks applies CB_S7a All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 30 minutes >0 Review of monthly Service Quality Performance Report £200 per Service User waiting over 30 minutes in the relevant month Monthly A+E CB_S7b All handovers between ambulance and A & E must take place within 15 minutes with none waiting more than 60 minutes >0 Review of monthly Service Quality Performance Report £1,000 per Service User waiting over 60 minutes (in total, not aggregated with CB_S7a consequence) in the relevant month Monthly A+E CB_S8a Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes >0 Review of monthly Service Quality Performance Report £20 per event where > 30 minutes in the relevant month Monthly AM CB_S8b Following handover between ambulance and A & E, ambulance crew should be ready to accept new calls within 15 minutes >0 Review of monthly Service Quality Performance Report £100 per event where > 60 minutes (in total, not aggregated with CB_S8a consequence) in the relevant month Monthly AM CB_S9 Trolley waits in A&E not longer than 12 hours >0 Review of monthly Service Quality Performance Report £1,000 per incidence in the relevant month Monthly A+E CB_S10 No urgent operation should be cancelled for a second time >0 Review of monthly Service Quality Performance Report £5,000 per incidence in the relevant month Monthly A CR VTE risk assessment: all inpatient Service Users undergoing risk assessment for VTE, as defined in Contract Technical Guidance 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Monthly A Publication of Formulary Continuing failure to publish Publication on Provider’s website Withholding of up to 1% of the Actual Monthly Value per month until publication Monthly A MH MHSS CR R Duty of candour Each failure to notify the Relevant Person of a suspected or actual Reportable Patient Safety Incident (as per Guidance) [Insert as per local determination] Recovery of the cost of the episode of care, or £10,000 if the cost of the episode of care is unknown or indeterminate Monthly All Completion of a valid NHS Number field in mental health and acute commissioning data sets submitted via SUS, as defined in Contract Technical Guidance 99% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect of each excess breach above that threshold Monthly A MH MHHS Completion of a valid NHS Number field in A&E commissioning data sets submitted via SUS, as defined in Contract Technical Guidance 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect of each excess breach above that threshold Monthly A&E Completion of Mental Health Minimum Data Set ethnicity coding for all detained and informal Service Users, as defined in Contract Technical Guidance Operating standard of 90% Review of monthly Service Quality Performance Reports Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect of each excess breach above that threshold Monthly MH MHSS Completion of IAPT Minimum Data Set outcome data for all appropriate Service Users, as defined in Contract Technical Guidance Operating standard of 90% Review of monthly Service Quality Performance Reports Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £10 in respect of each excess breach above that threshold Monthly MH MHSS CB_B1 Percentage of admitted Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 90% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £400 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies CB_B2 Percentage of non-admitted Service Users starting treatment within a maximum of 18 weeks from Referral Operating standard of 95% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £100 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies CB_B3 Percentage of Service Users on incomplete RTT pathways (yet to start treatment) waiting no more than 18 weeks from Referral Operating standard of 92% at specialty level (as reported on Unify) Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £100 in respect of each excess breach above that threshold Monthly Services to which 18 Weeks applies Diagnostic test waiting times CB_B4 Percentage of Service Users waiting less than 6 weeks from Referral for a diagnostic test Operating standard of >99% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Monthly A C CR D A&E waits CB_B5 Percentage of A & E attendances where the Service User was admitted, transferred or discharged within 4 hours of their arrival at an A&E department Operating standard of 95% Review of monthly Service Quality Performance Report Where the number of breaches in the month exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold. To the extent that the number of breaches exceeds 8% of A&E attendances in the relevant month, no further consequence will be applied in respect of the month Monthly A+E U Cancer waits - 2 week wait CB_B6 Percentage of Service Users referred urgently with suspected cancer by a GP waiting no more than two weeks for first outpatient appointment Operating standard of 93% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Quarterly A CR R CB_B7 Percentage of Service Users referred urgently with breast symptoms (where cancer was not initially suspected) waiting no more than two weeks for first outpatient appointment Operating standard of 93% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Quarterly A CR R Cancer waits – 31 days CB_B8 Percentage of Service Users waiting no more than one month (31 days) from diagnosis to first definitive treatment for all cancers Operating standard of 96% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R CB_B9 Percentage of Service Users waiting no more than 31 days for subsequent treatment where that treatment is surgery Operating standard of 94% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R CB_B10 Percentage of Service Users waiting no more than 31 days for subsequent treatment where that treatment is an anti-cancer drug regimen Operating standard of 98% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R CB_B11 Percentage of Service Users waiting no more than 31 days for subsequent treatment where the treatment is a course of radiotherapy Operating standard of 94% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R Cancer waits – 62 days CB_B12 Percentage of Service Users waiting no more than two months (62 days) from urgent GP referral to first definitive treatment for cancer Operating standard of 85% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R CB_B13 Percentage of Service Users waiting no more than 62 days from referral from an NHS screening service to first definitive treatment for all cancers Operating standard of 90% Review of monthly Service Quality Performance Report Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £1,000 in respect of each excess breach above that threshold Quarterly A CR R CB_B14 Percentage of Service Users waiting no more than 62 days for first definitive treatment following a consultant’s decision to upgrade the priority of the Service User (all cancers) [Insert as per local determination] Review of monthly Service Quality Performance Report [Insert as per local determination] Quarterly A CR R Category A ambulance calls CB_B15_01 Percentage of Category A Red 1 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of Actual Monthly Value with an end of year reconciliation with 2% of the Actual Annual Value retained if annual performance is not met, or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B15_02 Percentage of Category A Red 2 ambulance calls resulting in an emergency response arriving within 8 minutes Operating standard of 75% Performance measured monthly with annual reconciliation Monthly withholding of 2% of Actual Monthly Value with an end of year reconciliation with 2% of the Actual Annual Value retained if annual performance is not met, or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM CB_B16 Percentage of Category A calls resulting in an ambulance arriving at the scene within 19 minutes Operating standard of 95% Performance measured monthly with annual reconciliation Monthly withholding of 2% of Actual Monthly Value with an end of year reconciliation with 2% of the Actual Annual Value retained if annual performance is not met, or the withheld sums returned (with no interest) if annual performance is met Monthly withholding, annual reconciliation AM Mixed sex accommodation breaches CB_B17 Sleeping Accommodation Breach >0 Verification of the monthly data provided pursuant to Section B Part 14 in accordance with the Professional Letter £250 per day per Service User affected Monthly A CR MH Cancelled operations CB_B18 All Service Users who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the Service User’s treatment to be funded at the time and hospital of the Service User’s choice Number of Service Users who are not offered another binding date within 28 days >0 Review of monthly Service Quality Performance Report Non-payment of costs associated with cancellation and non- payment or reimbursement (as applicable) of re-scheduled episode of care Monthly A CR S Mental health CB_B19 Care Programme Approach (CPA): The percentage of Service Users under adult mental illness specialties on CPA who were followed up within 7 days of discharge from psychiatric in-patient care Operating standard of 95% Review of monthly Service Quality Performance Reports Where the number of breaches in the Quarter exceeds the tolerance permitted by the threshold, £200 in respect of each excess breach above that threshold Quarterly MH MHSS