The objective of the project was to streamline payments for joint funded packages between NHS Midlands and Lancashire (NHS ML) and Staffordshire County Council by moving to a monthly electronic process.

Background

We previously used a paper-based process which in some cases could take over six months to reconcile due to disputes. As a result, the full payment would be withheld until there was an agreement on the full payment list, a process which was very resource-intensive.

Action

NHS ML currently uses adam for their commissioning and case management systems, so using the same system for this project was a good fit.

Project governance included weekly meetings between adam, NHS ML and Staffordshire project stakeholders. In these meetings the completion of project milestones was tracked and potential risks were raised. The category went live on time and the first payment was made within the agreed timeline.

This new category has been set up as a collaboration between NHS ML and Staffordshire County Council, where NHS ML use the new category to manage the reimbursement of the local authority for the payment of joint-funded packages of care.

Staffordshire council has a provider (read-only) view of their joint funded packages of care, but is able to track changes to any particular package, such as a rate change, throughout the process.

Payment receipts are automatically generated monthly so that both parties can reconcile the receipts. Once the checks have been completed, invoices are paid to adam by CCGs and then the payment is made to Staffordshire County Council through their system. If any clawbacks or other changes need to take place, NHS ML can raise a change order and the system will automatically reconcile the difference by generating adjustment receipts.

Impact

The new process has resulted in:

• Quicker payments and improved cashflow
• Centralised online storage, records cannot be lost or damaged
• The system configuration has been set up and is ready to go
• Automatic Service Receipt (invoice) generation within the system
• The local authority (LA) will benefit from transparency and visibility of packages of care
• The LA will view the same package details as NHS ML
• Full audit trail available, including an audit of any changes
• Improved reporting functionality available to the LA and NHS ML
• Payments can be made on a regular basis (monthly)
• LA and NHS ML can review the invoice files generated by the system before payment is finalised
• Any disputes can be removed from the invoice file and investigated separately
• Only disputed invoices will be withheld from payment

Before the project, the average time to pay invoices for the 2019/20 financial year was 376.6 days – the average payment time is now 30 days as standard. At the end of 2020/21 financial year there were no outstanding debts owed to the council for this cohort of packages – for 2019/20 there was a debt owed of £9.2million at the finance year end. The improvement in terms of cashflow and the time taken to resolve the level of queries and reconciliations has been significant.

“Cashflow has been significantly improved. Originally it could take up to 6 months to reconcile and agree any disputes before any payments were made to Staffordshire council. We now get paid monthly and any disputes do not stop payments from being processed. The implementation of this solution means there is full transparency over the data which means when the invoice files are shared, there is a significantly less amount of time we are spending reconciling invoices.”

Karen Webb, Joint Funding Lead, Staffordshire County Council