What is Any Qualified Provider?
As part of the Government’s commitment to increasing choice for patients in NHS-funded services, the Government have specifically committed to extending patient choice for appropriate services through the Any Qualified Provider (AQP) scheme. The scheme is a way for the NHS to commission a range of services, in various settings, for certain conditions. This has been made possible due to the changes in the Health and Social Care Bill of 2012, which gives NHS clinical commissioning groups the power to commission such services1. The AQP scheme should allow patients who have been referred for certain services to choose from a list of providers who meet NHS service quality requirements2. Patients can choose a service based on what is important to them; they may prefer a service closer to home or with a shorter waiting list, for example3. The amount of money that providers will be paid for their services will be predetermined by the NHS.
The rational for extending patient choice via AQP is to
- give patients the right to choose a service that best suits their needs;
- improve the quality of services and provide levers for the best quality services to grow;
- encourage innovation by making it easier for new providers to offer services4.
An introduction to AQP by the Department of Health
Where does osteopathy fit in?
One of the services available to patients on the AQP scheme is Musculoskeletal (MSK) services for back and neck pain; osteopathy is included as an appropriate service, along with physiotherapy, chiropractic and acupuncture.
The aim of MSK services for back and neck pain is to provide community-based assessment, treatment and management of the back and neck. This means that in areas where commissioners are inviting applications from providers of MSK services, osteopaths can apply to qualify as a provider.
The service requirements have been designed considering:
- NICE guidelines for low back pain: early management of persistent non-specific low back pain;
- Map of Medicine pathways for low back pain – initial management and for neck pain;
- Musculoskeletal Services Framework;
- learning from existing service model studies, for example, Guden et al, 2012.
The commissioner may also consult the NHS Confederation’s resource pack on developing MSK networks which offers a framework for commissioners.
The service objectives are:
- To give patients a choice of provider
- To provide improved access to services closer to home
- To reduce waiting times to access the service and deliver treatment to enable patients to reach their individual treatment goals sooner. This could include an improved quality of life, return to work or more manageable pain.
- To deliver clinically effective treatments that reduce the demand on secondary care services and reduce the need for more costly interventions.
- To provide community services that have a strong emphasis on patient education and self-management, thereby promoting active, healthy lifestyles and reducing recurrence of injury or illness.
How can I become a Qualified Provider?
Step 1 – Register online
If you are interested in becoming a qualified provider, your first step will be to create an account on the Contracts Finder website. (Please note that as of 21st March 2014 the Supply2Health website has closed, to be replaced by Contracts Finder. Adverts previously placed on Supply2Health have been moved to Contracts Finder.)
Step 2 – Search AQP offers
Commissioning/procurement organisations decide which services can be procured using the AQP model; they will then place an AQP offer on the Contracts Finder website. The offer should contain details about the service specification, details of qualification criteria and specific local requirements.
Step 3 – AQP Application
Once you have found an AQP offer for MSK services for back and neck pain in your area that you wish to apply for, you can then begin the application process; this is done online.
You will be required to show your policies in each of the areas stipulated in your application.
Presenting evidence for osteopathy may also be required as part of your application. Resources are available on this website in the evidence for osteopathy section, in particular the snapshot summary of evidence for osteopathy. You can also download our document “Evidence for osteopathy for AQP applications“. NCOR have produced this specifically to assist your application.
Once you have submitted your application it will go through the AQP qualification process:
AQP QUALIFICATION PROCESS
The compliance team will check various details that you have included in your application, such as the details of your company or organization, your regulation details, for example with the General Osteopathic Council, and Information Governance Requirements.
Information Governance relates to the way organisations process and handle information, including how they will protect it from unauthorised access, loss, damage and destruction. The information can include personal information about patients and employees and finance and accounting records. Information Governance provides a way for employees to deal with information consistently whilst adhering to rules set out in various Government legislations including:
- The Data Protection Act 1998.
- The common law duty of confidentiality.
- The Confidentiality NHS Code of Practice.
- The NHS Care Record Guarantee for England.
- The Social Care Record Guarantee for England.
- The international information security standard: ISO/IEC 27002: 2005.
- The Information Security NHS Code of Practice.
- The Records Management NHS Code of Practice.
- The Freedom of Information Act 2000.
- The Human Rights Act article 8.
- The Code of Practice for the Management of Confidential Information (to be published in 2013)
All NHS organisations and third party organisations who have access to NHS patients and/or their information must show how they meet the requirements of Information Governance. As part of the AQP application process, potential providers must use the Information Governance Toolkit to self-assess themselves against these requirements to give evidence of their compliance. If, as a result of self-assessment, the provider finds they do not meet the requirements they must take appropriate measures to raise information governance standards within their organisation and detail how this will be achieved7.
Training in using the Information Governance Toolkit is available online at: https://www.igte-learning.connectingforhealth.nhs.uk/igte/
Service Delivery Assessment
Your qualification questionnaire will then be checked against the commissioner’s requirements to establish whether the provider’s service meets the service specification.
Financial Viability Checks
Your financial viability will be checked using the accounts you submit in the qualification questionnaire.
FINAL CHECKS BY THE LOCAL COMMISSIONING BODY
This stage is lead by the commissioner.
Any locally set questions in the questionnaire will be assessed at this stage, which will conclude the online process of your application.
The conclusion of this assessment results in providers being classified as either ‘Qualified’ or ‘Not qualified’. If you are ‘qualified’ you will then be listed in the national directory of qualified providers.
A contract will then be offered with an effective date.
APPLYING TO AQP IN THE FUTURE
If you are considering applying to become a qualified provider in the future, it would be helpful to have some data available which describes your current practice profile. This type of data could be in various forms including standardised data collection, clinical audit and outcome data using a recognised Patient Reported Outcome Measure (PROM) e.g, the Bournemouth Questionnaire. In addition, as mentioned above, you may be required to present evidence for osteopathy. Resources are available on this website in the evidence for osteopathy section, in particular the snapshot summary of evidence for osteopathy.
1. Health and Social Care Act. 2012 http://www.legislation.gov.uk/ukpga/2012/7/contents
2. Operational Guidance to the NHS: Extending Patient Choice of Provider. Department of Health, 2011 https://www.gov.uk/government/publications/operational-guidance-to-the-nhs-extending-patient-choice-of-provider
3. Any Qualified Provider. NHS Choices, 2012 http://www.nhs.uk/choiceintheNHS/Yourchoices/any-qualified-provider/Pages/aqp.aspx Accessed 05/07/2013
4. Discussion paper: Any Qualified Provider. The NHS Confederation 2011 http://www.nhsconfed.org/resources/2011/06/any-qualified-provider
5. Gurden M, Morelli M, Sharp G, Baker K, Betts N, Bolton J. Evaluation of a general practitioner referral service for manual treatment of back and neck pain. Prim Health Care Res Dev. 2012 Jul;13(3):204-10. doi: 10.1017/S1463423611000648. Epub 2012 Jan 30. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22284899
6. Information Governance Toolkit. Department of Health. https://www.igt.hscic.gov.uk/about.aspx?tk=64&cb=10%3a37%3a50&clnav=YES&lnv=5 Accessed 22/07/2013