NHS trusts accused of creating ‘dozens of Carillion-style meltdowns’ (The Guardian: 6 March 2018)
Growing numbers of hospital trusts are transferring staff into newly created private subsidiary firms in a move health unions warn will create a “two-tier workforce” in the NHS. Trusts are starting to see subsidiaries as a way of saving money after seven years of below-inflation annual budget increases and mounting financial problems due to an increased demand for healthcare.
Nineteen NHS trusts in England have already established a wholly owned subsidiary and begun transferring thousands of non-medical staff to them. Sixteen other trusts are considering doing the same in a fast-growing change in practice that they insist is intended to save money as employers, especially through paying less VAT. While private firms working for the NHS can claim back any VAT they are charged by the government, an NHS trust cannot, under the terms of the 1994 VAT Act....read more
Circle threatens legal action over £150m treatment centre procurement (HSJ: 27 March 2018)
Circle Health has pulled out of a bid to continue running services at the Nottingham Treatment Centre, and threatened clinical commissioning groups with legal action over their £150m three year procurement.
The company today issued a statement saying it had notified lead commissioner Rushcliffe CCG that it would be withdrawing from the tender process saying it does not provide a “sustainable basis” to deliver services at the treatment centre.
It said: “We now want to work with commissioners to ensure a fair, safe and sustainable service can continue for years to come at the Nottingham Treatment Centre. We will be exploring every possible option to make this happen, including legal challenge.”
The company did not provide any further detail on what specifically the focus of a possible legal challenge would be....read more
BMA slams 'confusion, chaos and failures' behind misdirected clinical letters (GPonline, 1 February 2018)
NHS England continues to receive between 5,000 and 10,000 items of clinical correspondence a month that have been sent in error by GP practices to Capita, according to a report by the National Audit Office (NAO).
Under rules introduced in May 2015, GP practices that receive clinical correspondence that does not relate to patients on their practice list are meant to return it to the sender. This marked a departure from previous arrangements, under which practices passed this data to their local primary care support service for processing and redirection to the correct practice.
The GPC says NHS England 'has still not launched an effective information campaign aimed at GPs' despite continuing confusion among practices two years after the rule change. And despite thousands of letters continuing to be sent to Capita, the private provider's primary care support contract does not require it to redirect letters. ...read more
NHS trusts forced to find new transport services as firms exit market (HSJ: 8 December 2017)
London hospital trusts have been forced to bring patient transport services in house or re-tender them as incumbent firms exit the market.
Barts Health Trust in east London has confirmed it is bringing its patient transport contract in house after provider ERS stopped providing the service. ERS is owned by American firm SRCL and also ran services across the east of England and Yorkshire.
The company had been running the service since July 2014. In its most recent board papers, the trust said its in house provision, which began in October, was cheaper.
London North West Healthcare Trust, which serves a population of more than 700,000 people from three hospital sites in outer London, was hit by the collapse of Essex based firm Private Ambulance Service last month.
The company employed more than 300 staff and also served Hertfordshire and Bedfordshire as well as the Royal Brompton and Harefield Hospitals Foundation Trust.
Private Ambulance Service was providing non-emergency patient transport to LNWH since February 2016, having won a five year contract from a framework set up by the London Procurement Partnership....read more
CQC flags up 'deep concerns' with independent rehab providers (HSJ: 30 November 2017)
People with drug and alcohol addiction are being put at risk of harm at many independent residential rehabilitation units, a new report has warned.
The Care Quality Commission published the report today revealing nearly three-quarters of private clinics were failing to hit regulatory standards of care.
The briefing was based on inspections of 68 independent services providing residential detoxification services over the last two years.
The CQC required 49 providers (72 per cent) to make improvements because they had breached regulations of the Health and Social Care Act 2012 and failed to meet fundamental standards of care.
It took enforcement action against eight providers. Forty-one providers breached two or more regulations and 25 breached three or more....read more
Trust faces £48m repair bill for PFI hospital (HSJ: 29 November 2017)
A trust faces a £48m repair bill to make one of its hospitals safe because of loopholes in the drafting of its private finance initiative contract, Department of Health documents reveal.
Documents released to HSJ under the Freedom of Information Act show Lewisham and Greenwich Trust asked for money “essential to ensure patient safety” following power cuts, water shortages and floods....read more
Commissioners settle with Virgin following contract dispute (HSJ: 27 November 2017)
A legal dispute between Virgin Care and six Surrey clinical commissioning groups has been resolved – with an apparent payment by the NHS to the company.
The litigation – over a £82m procurement of children’s services across Surrey – was launched after the three year contract was awarded to Surrey Healthy Children and Families Services – an alliance between Surrey and Borders Partnership Foundation Trust and two local social enterprises.
Virgin Care Services started High Court proceedings against NHS England, Surrey County Council and the CCGs in November last year. It said there were “serious flaws in the procurement process” which had left it “so concerned” that it had launched the proceedings.
However, governing body papers for NHS Surrey Downs – one of the six CCGs involved - have revealed that its “liability” in the case is £328,000. The sum was published this month in a finance paper covering October on the CCG’s website. The paper was uploaded earlier this week but subsequently removed after HSJ started to enquire about the settlement. A CCG spokesperson said the reference had been removed because “the level of detail…should not have been included in the report.”...read more
Labour demands inquiry into delayed payments to trainee GPs (The Guardian: 3 November 2017)
Labour is demanding an inquiry into how trainee GPs did not receive their salaries from a private firm that is meant to pay them on behalf of the NHS.
Jonathan Ashworth, the shadow health secretary, has urged Jeremy Hunt to act after the Guardian disclosed that the delays had led to some family doctors being unable to pay their mortgage and having to seek help from a charity.
The British Medical Association (BMA) believes hundreds of doctors in England have been left out of pocket as a result of the errors by Capita.
Labour wants the Department of Health (DH) to step in to cover monthly salary payments due to trainee GPs which they did not receive from Capita in order to prevent hardship.
“I’m sure you would agree that trainee GPs seeking charitable support to feed their families and being unable to cover their mortgages is an entirely unacceptable situation which requires urgent rectification,” Ashworth wrote.
Capita won a four-year contract from NHS England, worth a reputed £1bn, to provide a range of support services between 2015 and 2019 to GPs in three areas of England – the Thames Valley, Yorkshire and the Humber, and part of Wessex – including paying trainee GPs’ salaries.... read more
Exclusive: CCG resists Virgin Care demands for more money (HSJ: 23 October 2017)
Virgin Care has demanded more money for a controversial prime provider contract it signed with commissioners in Staffordshire last year, HSJ has learned.
East Staffordshire Clinical Commissioning Group has said it is “resisting” requests from the company for more money for the £270m prime provider contract.
Virgin is responsible for commissioning services for people with long term conditions
Both the CCG and Virgin Care have refused to confirm the amount being asked for, however, sources have told HSJ the private provider has asked for nearly £5m extra....read more
'Inadequate' private provider to hand back troubled contract early (HSJ, 21 September 2017)
A company operating one of the first integrated NHS 111 and GP out of hours services is to hand back the contract to the NHS.
Primecare was placed in special measures last month after its services in East Kent were rated inadequate by the Care Quality Commission – only seven months after it started full operations. Failings included not having enough staff to meet patient needs and not assessing risks to patients’ health.
A meeting of Kent County Council’s health overview and scrutiny committee yesterday was told the company planned to hand back the contract mid term. The contract was for three years, with an option to extend for another two.
Simon Perks, chief accountable officer for Ashford and Canterbury and Coastal clinical commissioning groups, told the committee: “The contractor has given us notice and will be leaving the contract on 7 July next year.”
He stressed that the four east Kent CCGs were working with the provider to address the issues in the CQC report and they were being supported by NHS England. A review of the procurement process would also take place. ...read more
NHS 'leaking millions' in PFI contracts (BBC News: 30 August 2017)
The NHS is "leaking" money to private companies in contracts to build and run hospitals, a report says.
Under the Private Finance Initiative (PFI), companies provide money for new hospitals and then charge annual fees.
The Centre for Health and the Public Interest (CHPI) publication - based on 107 PFI contracts in England - said such companies had made pre-tax profits of £831m in the past six years.
The Department of Health said less than 3% of the NHS budget was spent on PFI.
PFI has always provoked vigorous debate about whether the benefit is worth the long-term cost.
The CHPI argues the money made by private companies could have been spent on patients.
Colin Leys, one of the chairmen of the CHPI, said: "This report shows for the first time the huge amount of taxpayers' money which is leaking out of the NHS through the profits generated by PFI companies.
"Given the extreme austerity in the NHS, where patients are being denied treatment and waiting times for operations are rising, the government needs to take action to stop this leakage of taxpayer funds out of the NHS."....read more
Government accused of 'wasting millions of pounds' as it abandons sale of NHS staffing agency (The Independent: 7 September 2017)
Ministers have been accused of “wasting millions of pounds” after abandoning the controversial sale of an NHS staffing agency.
Public services union Unison protested that exploring the aborted privatisation of NHS Professionals had involved “filling the pockets of management consultants”, at a time of a recruitment crisis.
The Department of Health abandoned the sale on Thursday of the agency that supplies more than 90,000 doctors, nurses and other healthcare workers, after failing to receive any adequate bids.
The proposal had been strongly criticised because the use of NHS Professionals saves the NHS about £70m a year by supplying staff more cheaply than private sector agencies.
Embarrassingly, it is the second privatisation halted within a year, after a plan to sell off the Land Registry, the body that records the ownership of property, was shelved last September.
Labour hailed the announcement as a “major U-turn on a misguided policy from a Government with no solution to the workforce crisis in the NHS”....read more
Labour demands inquiry into privatisation of NHS-owned recruiter (The Guardian: 27 July 2017)
Labour is demanding an inquiry into the privatisation of a government-owned NHS recruitment firm that saves hospitals £70m a year.
NHS Professionals helps the health service in England tackle its staffing crisis by arranging for doctors and nurses on its books to cover potentially harmful gaps in rotas.
Labour has asked the National Audit Office to look into why Jeremy Hunt, the health secretary, is selling a profitable and effective company his Department of Health owns. The firm should be kept in public hands and allowed to continue playing a key role in alleviating widespread NHS understaffing, the party says.
Justin Madders, the shadow health minister, has written to Sir Amyas Morse, the comptroller and auditor general who heads up Whitehall’s spending watchdog, asking him to intervene before a sale is finalised, possibly as soon as next month.
“On the government’s own estimates NHSP saves the taxpayer around £70m a year by organising last-minute or replacement staffing for NHS trusts in England, and ensuring hospitals don’t have to rely on expensive private agencies”, Madders writes.
He wants the NAO to “examine the business case that has been produced [by the DH] to ascertain a better understanding of what additionality the private sector can bring to what on the face of it is already a successful organisation.”
NHSP supplies staff cheaper than those obtained through private agencies which Simon Stevens, the chief executive of NHS England, has castigated for charging “rip-off” rates.... read more
GPs claim quarter of a million in missing payments from Capita and NHSE (Pulse: 7 July 2017)
GPs are seeking to claim a quarter of a million pounds in unpaid bills from NHS England, its support services provider Capita and other NHS organisations, after a GP pressure group enlisted debt collectors.
Pulse revealed last week that campaign group GP Survival was asking GPs and practices to come forward with details of missing payments since Capita was handed the Primary Care Support England contract.
GP Survival chair Dr Matt Mayer told Pulse that in less than a week he had been approached by 25 GPs or practices owed payments ‘approaching a quarter of a million’.
The debt collection group have assigned a case agent to review each complaint and determine whether the debt was recoverable and whether that would be from NHS England, Capita or another party.
Capita told Pulse it had not been approached by GP Survival directly but said GPs should use the ‘usual channels’ to contact it with any problems and it would solve them ‘as quickly as possible’.
Its support service division does have a support line for enquiries and complaints, but the latest satisfaction survey shows 61% of its users are dissatisfied with how effective this process is.
The contract, which runs from 2015-2021, ran into problems soon after services transferred from local offices to Capita's new national function, this included trainees going unpaid nationwide, missing payments and a log-jam in performers list applications that left qualified doctors sitting at home for six months.
The cases he had been sent included practices where partners had taken pay cuts or not taken their drawings ‘because they’re paying registrars out of their own pocket'.
Dr Mayer said: ‘I’m getting a few emails a day from practices or doctors, at the moment I’ve got a list of about 25 cases, each one averaging about ten grand.
‘So you’re getting up to about a quarter of a million quid in combined debt, and that’s in less than a week.
‘We’re trying to break that cycle, the system of emailing and escalating things hasn’t worked.’....read more
DH spends £2m on stalled NHS Professionals sale (HSJ: 6 July 2017)
The Department of Health has spent nearly £2m on the stalled sale of a majority stake NHS Professionals, the health service’s in-house temporary staffing agency.
The DH has spent £1.9m since February 2015 on lawyers and consultancy firms while it investigates selling a majority share in the company.
Philip Dunne said NHS Professionals saved the NS £70m a year
NHS Professionals, which is wholly owned by the DH, was set up in 2010 and works with 55 NHS providers to supply temporary staff. Previously it was part of the department.
The sum spent on the project, known as “Project Florence”, from 2015 to April 2017 includes: £997,000 with Deloitte; £459,000 with Pinsent Masons LLP; and £442,000 with PwC.
Health minister Phillip Dunne said in November that NHS Professionals saved the health service over £70m a year.
The DH has not confirmed whether it has issued a tender to invite bidders to take a majority share in the company, as Mr Dunne said was planned.
Mr Dunne noted the continuing effort in the NHS to reduce spending on agency staff, which reached £3.7bn in 2015-16, and said further investment in NHS Professionals would help achieve this....read more
Terrifyingly, the NHS is about to get some of its money from hedge funds – this will be quantum leap in privatisation (The Independent: 9 May 2017)
It is assumed that benefits will trickle down to patients, but this isn’t how hedge funds work. They are there to make a profit for investors
Privatisation has long been held up as a panacea to the NHS’s problems. The first ‘PFI’ (Private Finance Initiative) schemes in the 90s were hailed as a possible solution to the NHS’s difficulties in funding large capital projects, like new hospital buildings, under the Major and Blair governments. Since then, it’s been estimated that taxpayers’ money will be used to pay more than five times over what those PFI assets are worth, at £57bn. Private money into the NHS meant public liability, many times over, for no private risk.
But far from taking the lesson that private money to fund the NHS causes it greater problems, the NHS leadership’s most recent move to meet its under-funding is to approach City hedge funds to borrow £10 billion. This marks a quantum leap in privatising our NHS....read more
Private provider beats GP federation to NHS contract (HSJ: 18 April 2017)
Commissioners in north London have awarded an extended primary care services contract to a private provider over the GP federation that was already providing the service, HSJ has learned.
Camden Clinical Commissioning Group has appointed AT Medics, a private provider of primary care services, as its extended GP access provider following a procurement process. It is a GP led provider of various primary care services in London, including core GP services and urgent care.
This was despite a receiving bid from the Haverstock Healthcare, a GP federation operating in the borough, and which currently provides the service. It covers 200,000 patients across 26 GP practices in Camden.
HSJ understands that the contract has been awarded as part of a joint procurement process for extended GP services accross five North central London CCG areas – Camden, Haringay, Islington, Barnet and Enfield – related to the national GP access fund.
In a message to local GPs, Rebecca Thornley, assistant director of primary care at Camden CCG, said: “AT Medics, who run King’s Cross Surgery, demonstrated their understanding of the local health system and the needs of Camden patients through the bidding process....read more
Virgin Care and CCG in dispute over changes to £270m contract (HSJ: 11 April 2017)
A Midlands clinical commissioning group is locked in a contract dispute with Virgin Care over a controversial “prime provider” contract awarded last year, HSJ has learned.
East Staffordshire CCG disagrees with “contractual claims” made by the independent provider to make changes to the £270m “prime provider” deal that began in May 2016.
The fixed price, seven year contract covers community services, with Virgin Care coordinating services for frail elderly patients, people with long term conditions and intermediate care. Last year, the CCG said it had used the prime provider contract model as it did not have the capacity to deliver the required integration of services.
However, in governing body papers published on 30 March, the CCG said there have been “a number of contractual claims made by Virgin Care for variations to the contract… these continue to be managed through the prescribed contract management and dispute resolution processes”. It is not clear what the nature of these claims are.
The documents also said the CCG is utilising a number of “contractual actions” in relation to Virgin Care in its prime contractor role, and the outcome of “contractual claims made by Virgin Care” present a “potential risk” to the group’s finances....read more
Flagship £690m cancer procurement abandoned over financial fears (HSJ: 10 April 2017)
A controversial tender for cancer services in Staffordshire worth £687m has been abandoned after a consortium led by a private provider failed to convince commissioners its offer was financially viable.
The tender process for the 10 year, prime provider contract has been running since 2013 and HSJ understands the procurement has cost the four Staffordshire CCGs more than £840,000.
Only one bidder, a consortium led by Interserve, remained in the running for the contract. The consortium also included University Hospitals North Midlands Trust and The Royal Wolverhampton Trust.
The decision by commissioners not to award the contract on financial grounds follows the collapse of the £800m UnitingCare Partnership contract, which was abandoned in December 2015 eight months after going live.
As a result, procurement of the Staffordshire cancer contract and a separate £535m end of life care contract were paused for several months while a review was carried out. The process resumed in November.
Andy Donald, chief officer at Stafford and Cannock Chase CCGs, who was leading on the project, told HSJ today that he was “disappointed” commissioners had not been able to award the contract.
He said: “The remaining bidder couldn’t convince us they could deliver with the resources available. They couldn’t meet the required evaluation criteria.”
He said the work that had been done, including setting out clear outcome measures for cancer care in the county, would be used to hold individual providers of cancer services to account for improvements.
The contract was designed to deliver service integration through a single prime provider that would be responsible for commissioning services measured against outcomes agreed by commissioners, including full recovery, longer life expectancy or pain free dignified deaths....read more
Biggest ever NHS tender launched as £6bn contract put on market (HSJ: 7 April 2017)
Manchester health leaders have kicked off the search for providers of “out of hospital” health and care services across the city under a contract worth nearly £6bn – the largest ever NHS services tender.
A tender document, published by NHS Shared Business Services, sets out for the first time the contract value and other details of the ambitious plan to set up a “local care organisation” to provide all non-acute services – including social care – across the city.
The LCO will hold a single 10 year contract to provide services for a population of around 600,000 across the city – but not the entire Greater Manchester devolution region. The contract will be let by Manchester Health and Care Commissioning, a partnership between the city council and a newly formed single clinical commissioning group.
The notice, which calls for expressions of interest by the end of April, said: “Commissioners seek responses from interested providers who wish to deliver… a local care organisation for the population of Manchester with the aim of bringing together a range of health, social care and public health services to be delivered in the community.”
“The LCO is envisaged [to have] an emphasis upon: local population health and prevention of ill health; connecting to community assets and building upon people’s strengths and self-management skills; and targeted care support people’s needs particularly as needs change and become more complex. The estimated total contract value for the 10 year contract term is £5.9bn.”...read more
CCG pays ambulance staff wages following private provider dispute (HSJ: 22 March 2017)
Commissioners in Sussex paid a total of £642,000 in wages to former NHS staff after their private company employer ceased trading, HSJ can reveal.
Alan Beasley, the chief finance officer for High Weald and Lewes Clinical Commissioning Group, said he would be “exploring all avenues” to recover the cash from Docklands Medical Services, which provided patient transport services in Sussex until it ceased trading last summer.
He insisted that the payment will not set a precedent for other private providers to expect a bail out.
The circumstances of the payment were “unique”, Mr Beasley told HSJ. “We are not setting a precedent in terms of other private sector contracts that we might have. Those were ex gratia payments, not contractual payments.”
The 71 former South East Coast Ambulance Service Foundation Trust workers at the centre of the dispute twice lost their jobs when two private patient transport companies – VM Langfords and Docklands Medical Services – ceased trading in rapid succession last summer....read more
Deer Park Medical Centre: Campaigners to fight on after closure (BBC: 24 March 2017)
Campaigners have said they will fight to reopen an Oxfordshire doctor's surgery forced to close.
Witney's Deer Park practice will close later, leaving 4,000 people to look for new doctors. Oxfordshire Clinical Commissioning Group said it had not found a new provider to run the practice after its contract with Virgin Care ended.
Health secretary Jeremy Hunt ruled it would not be safe to keep it open with no provider in place.
Campaigner Yvonne De Burgo said: "We intend to fight on, to get it back open and running as good as it was before, either with Virgin Care or not.
"We have all had to go elsewhere and we haven't wanted to, and we are not getting as good a service as at Deer Park.
"That's not the fault of the other practices, they are just overwhelmed, they could only barely cope before."
Witney MP Robert Courts had said the "vital community asset" needed to stay open.
The decision to shut the practice has been referred to an independent reconfiguration panel, but it is not due to report back until 11 April.
Circle contract win means trust 'risks going in special measures' (HSJ: 14 March 2017)
A struggling NHS trust could lose up to £6.6m of income and risk being put into financial special measures after losing a £73m contract, a report has found.
Lewisham and Greenwich Trust stands to lose up to £6.6m of revenue over five years unless Circle Health, the winner of a musculoskeletal contract for Greenwich, contracts it to deliver community based services and “other orthopaedic activity”, the PwC report said.
The report also highlighted possible risks to the safety of care if Circle subcontracts MSK services currently provided by Lewisham and Greenwich to another provider.
The London trust already has a forecast deficit of £34.6m for 2016-17, which puts the trust’s finances £14.4m behind plan, the PwC study said.
The loss of £1.6m of income in the first year of the three year contract could “add additional financial pressures to the trust”, and lead to “potential intervention, for example being placed into the financial special measure regime”, the report said....read more
Virgin Care starts legal proceedings against NHS (HSJ: 13 March 2017)
A private provider has launched legal proceedings against eight NHS commissioners after losing a bid for a £82m children’s community services contract.
Virgin Care Services Limited issued court proceedings in the High Court against NHS England, Surrey County Council and the county’s six clinical commissioning groups one month after commissioners awarded the three year contract to Surrey Healthy Children and Families Services Limited Liability Partnership.
The winning bidder is an alliance between Surrey and Borders Partnership Foundation Trust and two social enterprises, CSH Surrey and First Community Health.
A spokesman for Virgin Care Services told HSJ that concerns about “serious flaws in the procurement process” prompted the company to launch proceedings.
“Never before have we been so concerned with the whole process that we have needed to make a challenge of this nature,” the spokesman said....read more
Revealed: millions paid to social care companies amid crisis in standards (The Guardian: 3 December 2016)
An investigation into the five biggest firms providing homecare services in the UK has found millions of pounds has been paid to some owners amid a crisis in standards of care.
An analysis of published reports from the Care Quality Commission, the care regulator for England, reveals that of the 192 domiciliary care services run by major companies, and inspected over the last two years, 80 were found to “require improvement”, with eight found to be “inadequate” and placed into special measures.
In services rated inadequate, people were found to be unwashed, unfed, unable to get out of bed and left at risk of harm. In some cases, medicine was not given on time or safely and services were described as unsafe and short-staffed. Yet, in the past five years, an analysis of care records and company accounts by Corporate Watch reveals evidence of £36m being paid to owners, with a further £34m in liabilities being stacked up in company accounts.
The revelation follows an announcement last week by the Competition and Markets Authority that it was launching an investigation into the sector, after concerns were raised about unfair practices and high bills....read more
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