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Integrated Support and Assurance Process (ISAP)

14 November 2016

NHS Improvement and NHS England have released details of a new Integrated Support and Assurance Process (ISAP) for assuring novel or complex (including New Care Model) procurements/commissioning. This guidance is an introduction to the process and full guidance is not expected to be released until later in the year.

The ISAP is intended to provide a consistent and streamlined process, to help support the successful delivery of the complex contracts and organisational forms that are emerging. It incorporates lessons learned from the Uniting Care Partnership transaction and the ISAP’s stated objectives are to:

  1. Ensure that proposals represent a good solution in the interests of patients and the public
  2. Ensure a system view has been taken of the potential consequences of contract award
  3. Enable the risks of the complex contract to be identified, understood and mitigated as far as possible
  4. Deliver efficiency and reduce duplication in the work of NHS England and NHS Improvement, increasing the speed of the national due diligence for complex contracts.

The ISAP exists alongside existing processes and introduces three 'checkpoints' (after an initial 'early engagement' phase) at various stages in the commissioning process.

When will the ISAP apply?

The guidance states that:

“The ISAP is intended to support all novel or complex procurements by commissioners. Specifically, if contract forms, risk sharing arrangements or calculations of the contract value are taking a previously unused approach, or if potential providers are creating legal entities involving new organisational forms, the ISAP will apply.

This includes, but is not limited to, the commissioning of systemically significant new care models, such as multispecialty community providers (MCP), primary and acute care systems (PACS) and any Accountable Care Networks that result in significant change in whole health systems. Because of their smaller scale, it is not envisaged that the ISAP will apply to some other varieties of new care model, such as Enhanced Care in Care Homes.”

The guidance also provides other examples – e.g. where ranges of services are being integrated or population-based budgets or significant levels of payment linked to outcomes are proposed - but the guidance states that these example are not exhaustive and, if there’s any doubt, commissioners should engage with their regional NHS England teams as early as possible.

Please do contact us if you have any questions about the ISAP or when/how it may apply.

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The content on this page is provided for the purposes of general interest and information. It contains only brief summaries of aspects of the subject matter and does not provide comprehensive statements of the law. It does not constitute legal advice and does not provide a substitute for it.

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