The Health and Social Care Act (2012) states that Monitor will take on a new role in supporting commissioners to ensure that, in the rare event of the failure of a healthcare provider, patients could continue to access the care that they need.
In the first instance, the continuity of service regime outlined in the Act gives Monitor a duty to prevent providers from taking actions that could undermine their continued ability to deliver services. However, it is commissioners, overseen by the NHS Commissioning Board, who will have a primary responsibility for ensuring the continuity of service provision.
Monitor will have powers to assist providers in significant difficulty – for example, Monitor could require a provider to appoint turnaround experts to help them deal with financial difficulties and avoid failure, or, as a last resort, appoint a continuity administrator to take control of the provider’s affairs and work with commissioners to ensure that patients continue to have access to essential services.
In circumstances where providers do experience difficulties, it will be Monitor’s duty to come up with a source of finance to draw upon in order to put the mechanisms in place to help the provider tackle the problems. Monitor is most likely to do this through the creation of a ‘risk pool’ - a fund which would be maintained by a levy on providers and commissioners.
This insurance-type mechanism – where the size of the levy could reflect a provider’s risk of becoming unsustainable - would create an incentive for providers to become more sustainable and thus reduce their levy.
Licensing will be the mechanism which ensures that Monitor can support commissioners effectively in securing continued access to NHS services.
If you have any questions about this area of Monitor's proposed new role, please contact Paul Devenish at Monitor.