Service Level Agreement
Version - Final – 22/06/12
Accredited OH provider name & Trust logo
this is a TEMPLATE DOCUMENT DESIGNED TO BE TAILORED TO REFLECT LOCAL CIRCUMSTANCES
service level agreement
Service Level Agreement between [Name of Trust or OH Service] and [Name of Purchasing Organisation e.g. company name or name of host Trust]
Date Prepared: --/--/--
Contract Period: [Insert period of contract from – to]
Prepared For: Name here
Job Title
Organisation
Address 1
Address 2
City/Town
Postcode
Prepared By: Name here
Position: Position here
Organisation: Organisation here
[insert Trust logo]
Service Level Agreement
Version - Final – 22/06/12
1. Introduction
This Service Level Agreement (SLA) specifies the arrangements for the provision of a comprehensive occupational health service to [name of purchasing organisation], hereafter referred to as the Purchaser, by the OH service, hereafter referred to as the Provider.
Occupational Health (OH) provides a complex managed clinical service. It provides a mix of high frequency transactions (e.g. referrals and immunisations) with lower frequency events that can have a high impact and are highly valued by managers and staff but are difficult to measure (e.g. doctors in difficulties).
The delivery of the OH service is underpinned by the following principles;
· Strong focus on a high quality, clinically-led, evidence-based service
· An equitable and accessible service
· Impartial, approachable and receptive to both clients and employer
· Contribute to improved organisational productivity
· Work in partnership with all NHS organisations and within the community
· Underpinned by innovation
· Offer diversity and depth of specialisation and training opportunities
This SLA is a document that defines in practical terms the responsibilities of both parties (Purchaser and Provider). It may supplement any formal legal agreement that may have already been defined.
2. Arrangements
The OH service is provided by [name of OH provider], hereafter referred to as the Provider.
This SLA is based on providing a comprehensive service to [x insert the organisation employee headcount] number of staff, as detailed in the attached scheduled.
These figures may increase or decrease by [x% insert the agreed percentage variation] without affecting the cost of the agreement. Variations outside these levels will be subject to discussion between the Purchaser and Provider to identify changes to the value of this SLA or amendment to the range of services or activity levels to be provided.
The agreed annual charge for the provision of this service is £x. This will be uplifted annually in line with the agreed NHS inflationary index, or the contracted activity levels adjusted to reflect a reduction or unchanged annual charge. In the event of over- or under-activity against contract, early and continuing discussions with both parties will take place to enable an in-year variation to the annual charge.
Payment method will be agreed at the commencement of each year, but will usually take the form of an agreed monthly and annual budget, and reflected in the Provider’s Income and Expenditure Budget Statement on a monthly basis.
3. Accreditation
The Provider is fully SEQOHS accredited (the national accreditation scheme for OH providers) against the six [A-F] national standards for Occupational Health plus the NHS standards [G](or have completed the preparation for accreditation and are awaiting a date for an accreditation visit from the SEQOHS assessment team). The Provider will be able to provide the evidence of conformance with each SEQOHS standard whenever this is requested by the Trust.
A. Business probity / Business integrity and financial proprietyB. Information governance / Adequacy and confidentiality of records
C. People / Competency and supervision of occupational health staff
D. Facilities and equipment / Safe, accessible and appropriate
E. Relationships with purchasers / Fair dealing and customer focus
F. Relationships with workers / Fair treatment, respect and involvement
G. NHS standards / Core NHS services, audit, business and clinical delivery standards
4. Minimum service standards
The Provider will also make services available that meet a minimum specification based on the following six core services (Domain G 1.1):
Prevention / The prevention of ill health caused or exacerbated by workTimely intervention / Early treatment of the main causes of absence in the NHS
Rehabilitation / A process to help staff stay in or return to work after illness
Health assessments for work / Supporting organisations to manage attendance and retirement
Promotion of health and wellbeing / Using the workplace to promote improved health and wellbeing
Teaching and training / Promoting the health and wellbeing approach amongst all staff and ensuring the availability of future occupational health staff
5. Clinical governance
The Provider is working towards a comprehensive system in place for clinical governance including processes that allow the Purchaser to achieve or maintain conformance with NHSLA Level 3 requirements.[1] These include standards for a competent and capable workforce, a safe environment, and learning from experience.
The NHSLA standards with relevance to the Provider include:
· Standard 1(9): Professional Clinical Registration
· Standard 1(10): Employment Checks
· Standard 3(5): Inoculation Incidents
· Standard 3(9): Supporting Staff Involved in an Incident, Complaint or Claim
· Standard 3(10): Stress
· Standard 5(1): Clinical Audit
· Standard 5(8): Best Practice – NICE
The Provider is in the process of participating in the national clinical governance and benchmarking tool for occupational health (known as MoHaWK) and will collate the necessary information to comply with this system once in place and as it develops. This is a major tool in the benchmarking of service quality and improvement, along with SEQOHS and local/national audit.
Relevant evidence-based guidelines on health at work support includes those produced by NICE and NHS Plus. The current guidance of relevance to the NHS workforce is listed in the table below:
NHS Plus guidelines / NICE workplace guidance Chronic fatigue syndrome / CG43 Obesity
Latex allergy / CG88 Low back pain
Infected food handlers / CG117 Tuberculosis
Physical/shift work in pregnancy / PH5 Smoking cessation
Dermatitis / PH13 Promoting physical activity
Upper limb disorders / PH19 Management of long-term sickness
Varicella zoster virus / PH22 Promoting mental wellbeing at work
The Provider will comply with the requirements for the Purchaser to produce an annual quality account1 which offers an opportunity to demonstrate how well commitments to staff in the NHS Constitution are met and describes plans to support improvements and measure the impact. This includes meeting the pledge to provide support and opportunities for staff to maintain their health, well-being and safety as detailed within the Constitution and the Public Health Responsibility Deal.
The National Health Service (Quality Accounts) Regulations 2010; Quality Accounts toolkit 2010/11. DH, 2010
5. Audit and Research
The Provider will provide an annual audit plan and provide periodic reports demonstrating the actions that have been taken as a result of audit. The Provider will participate in national audits of occupational health.
The Provider will contribute to research and development, as agreed with the Purchaser.
6. Staffing
The Provider has the mix of capabilities to meet the full range of occupational health needs of NHS staff.
The Provider ensures that specialist practitioners meet the recommendations for continuing professional development (CPD).
Registered specialists in occupational medicine will have the personal qualities and clinical expertise to act as a consultant for the NHS. (Any doctor applying for a consultancy post will hold either a CCT or a CESR in the specialty). [FOM/ANHOPS (2010) Enhanced Competencies for Occupational Physicians caring for Healthcare Practitioners].
The Provider contributes to the development of a sustainable specialist medical and nursing workforce. The Provider has a plan for the training of nursing or medical specialists either directly or through formal arrangements agreed with, and in support of, other OH training providers.
The Provider has a workforce development plan that describes career pathways and offers trainee doctors in key specialties the opportunity of a clinical attachment to an occupational health department as part of their training.
The Provider meets the SEQOHS Domain C stipulating the availability of the relevant qualified staff and skills required for the delivery of this SLA.
The Provider has arrangements in place to offer special expertise when it is needed by the Purchaser. These sub-specialist areas may include:
Blood borne viruses
Cytotoxics
Dermatitis/gloves
Ergonomics
Genetically modified organisms (and gene therapy)
Health surveillance and assessment
Immunisations
Occupational asthma
Outbreaks and disaster preparedness
Pre employment health assessment
Psychological and mental health support
Radiation
Research
Sick health and clinical professionals
Tuberculosis
7. Service continuity
The Provider has business continuity plans in place to deal with the loss or unavailability of key members of the occupational health team or in the event of force majeure, e.g. fire, pandemic, etc.
8. Clinical Information Exchange
The Provider will have arrangements in place to share information with other Providers where the bi-directional ESR is in place. In particular this includes the exchange of information concerning the immunisation status of staff.
The Provider will have arrangements to use the bi-directional information exchange system developed for ESR (the human resources database), as agreed with the Purchaser. This is essential for occupational health providers supporting trusts that are host employers for medical trainees.
9. Purchaser’s Responsibilities
In the event that the Purchaser provides facilities to the Provider, the Purchaser will ensure that these facilities available to the OH team are safe, accessible and appropriate for services provided, to include access for persons with disability, the provision of privacy and hand hygiene methods for examination and treatment rooms.
The Purchaser will cooperate with the Provider in facilitating the maintenance of an accurate employee database, including the establishment of a bi-directional interface with the ESR system.
The Purchaser will ensure that line managers requesting staff to work will have completed a risk assessment for each job area detailing any special requirements of the job.
The Purchaser’s HR department will be responsible for ensuring relevant applicants from risk assessment receive the employment medical questionnaire for new starters and are told to return it direct to the Provider.
The Purchaser will ensure that all new clinical recruits make an appointment with the Provider within two weeks of the start date, to have their immunisation status updated and checks undertaken.
11. Working Methods
The Purchaser and Provider commit to working together effectively and efficiently. The working processes and service delivery methods are outlined in Annex 1.
The Provider’s main OH service is located at x. The Provider will also deliver services from clinic rooms at different locations as agreed with the Purchaser from time to time.
12. Confidentiality and Record-Keeping
The Provider will maintain health records for all the Purchaser’s staff either paper and/or on computer/disc. Currently health records are retained for up to 40 years subject to whether COSHH applies. Non-COSHH records will be held for x years in accordance with local protocols.
The Provider will maintain confidentiality, and will adhere to all requirements of the Data Protection Act 1998, and Access to Medical Reports Act (1988) and Caldicott principles. The Provider, as an accredited OH service will have met the good practice and legislative requirements required for the purposes of information governance, including those defined within the SEQOHS standards.
The Provider will keep all records in the designated OH service in a locked and secure area until such a time that they can be scanned and destroyed.
The Provider will ensure that all information held in or pertaining to occupational health records is confidential to the OH staff on a need to know basis.
The Provider will ensure that all leavers’ files are marked and kept in a designated place within the department or other suitable and accessible place. Where possible records will be archived and stored on disc.
The employee’s written consent is required by law before access to clinical information can be provided to others. Confidentiality is not an absolute duty, therefore the Provider can disclose personal information under certain circumstances, including:
· if it is required by law
· with the employee’s consent
· if it is justified in the public interest, including for the protection of the employee him/herself and other staff, public or patients they may come into contact with
The Data Protection Act (1998) governs employee access to their medical records that include medical reports to management prepared by the Provider. It gives employees the right to see and have copies of their health records, including the content of any employer referral letters. The General Medical Council require the Provider to inform employees of their right to see reports before they are sent to their employers. Normally, employees give permission for reports to be sent to their employer at the same time they receive their copy. However, on occasions when this is not the case the Provider will notify the Purchaser that the report will be delayed for this reason. Employees have x working days to comment on the factual content of the report only, but not to challenge the medical opinion contained therein.
In the event of the lapse of this SLA, the Provider assures the Purchaser that the transfer of health records to the new OH Provider will be conducted in accordance with the approved regulations and protocols, and in-line with SEQOHS standards.
13. Organisational Governance
The Provider will work with the Purchaser as agreed to contribute to wider organisational governance and corporate objectives. Such arrangements will include, but not be limited to, attendance at the following:
Trust Health & Safety Committee
Clinical and Non Clinical Risk Management groups
Infection Control Committee
Corporate briefings and events, such as Trust Open Days and AGMs
Health & Well-being working groups
14. Performance Management and Metrics
The Key Performance Indicators (KPIs) and metrics for this SLA are detailed in the Annex. Quarterly reports will be produced in relation to performance against (KPIs), and measure of service usage. These quarterly reports will be in line with the NHS financial year, i.e. April – June; July – September, etc. An annual report will be completed including activity analysis for all services detailed in the contract. Performance will be discussed at formal meetings held between the Purchaser and Provider held on a quarterly basis.