Aligned Incentive Contract – LTHT and NHS E Specialised Commissioning & Leeds CCG

Leeds Teaching Hospitals NHS Trust has recently agreed (April 2018) an Aligned Incentive Contract with both its main commissioners (NHS Leeds Clinical Commissioning Group (CCG) and NHS England Specialised Commissioning. We are the first provider to have entered into this type of contract with NHS England Specialised Commissioning and this has been done on a 12month pilot basis. 
The Aligned Incentive Contract (AIC) is an alternate contracting and payment mechanism to Payment by Results (PbR) that will enable financially sustainable (from both a commissioner and provider perspective) services for the local population to be delivered going forward. This involves a change in behaviour and culture in all organisations, to ensure that there is transparent working and joint collaborative solutions.


  1. The fundamental benefit of the Aligned Incentive approach is that total service costs will be less than under the PBR system.
  2. It will mean that all stakeholders have a transformational mind-set that will enable greater clinical and financial sustainability of services.
  3. It will eliminate the fear commissioners have of uncontrolled cost increases, providing more accurate forecasting.
  4. The provider will be incentivised because it will be working within known income levels where the benefit of pathway changes and reductions in pass through costs are retained by the provider.
  5. It reduces the cost of contract management, freeing up personnel to contribute to service change and improvement activities to enhance patient experience.
  6. Facilitate commissioning across pathways which cross Specialised/Non-specialised and Acute/Non-Acute boundaries.
  7. Better enable the aim of “place-based” commissioning which is the direction of travel as outlined in the FYFV. 

We have run joint interactive training workshops alongside both commissioners during July/August 2018 and trained 220 staff over eight sessions, which have received positive feedback. 
It is a very exciting opportunity for the three organisations to work together colloaboratively, to ensure we provide the best services for our patients.