The “biggest privatisation yet” – CCGs told to delay signing £1.2bn deal on cancer and end of life services

Gareth Iacobucci for The BMJ reports: CCGs told to delay signing £1.2bn deal on cancer and end of life services ( BMJ 2016;352:i745 ), and NHSreality has already commented ( Cradle to grave? Why the cost of dying is rising.) on the inequalities, post code differences and inconsistencies in palliative care. 

A landmark £1.2bn (€1.6bn; $1.8bn) overhaul of services in Staffordshire for patients with cancer and for people at the end of life, dubbed by critics as “the biggest NHS privatisation yet,” has been put on hold until an inquiry into the collapse of a contract for older people’s care in Cambridgeshire has concluded.

The procurement of two contracts worth £700m for cancer care and £500m for end of life care in Staffordshire has proved controversial because of the sums of money involved and because it could lead to private firms directly running specialist services.1

The four clinical commissioning groups (CCGs) managing the procurement subsequently revealed that NHS and private sector bidders had come together to form a joint consortium, which was now the sole bidder for the contract.2

The procurement process was initially expected to conclude in December 2015 but has now been paused after NHS England’s regional team for the Midlands and East of England instructed the CCGs to delay signing a deal until the investigation into the collapse of the £800m Cambridgeshire contract was complete.

The Cambridgeshire deal, in which Uniting Care Partnership, a limited liability partnership formed by two NHS foundation trusts, would provide older people’s healthcare and adult community services was one of the largest outsourcing deals ever in the NHS. But it collapsed just months into operation after it was deemed “no longer financially sustainable,”3 prompting NHS England to commission an independent review.

Andy Donald, the accountable officer for three of the four CCGs in Staffordshire, acknowledged the need to learn the lessons from the collapse of the Cambridgeshire deal before progressing. He said, “The findings are expected to be published in February, and lessons learnt from the review will be used to make sure that the cancer and end of life contracts are robust and sustainable before any announcements are made.

“To ensure that the [Staffordshire] programme does not lose momentum, NHS England has encouraged commissioners and patients to continue with the work on both procurements. NHS England has asked commissioners to wait for the learning from the review before entering into any contractual commitments.

Donald added, “We welcome this assurance process, because it will ensure that the contracts are successful in delivering improved patient outcomes in cancer and end of life care.”

Commenting on the decision to pause the process, Wendy Saviour, director of commissioning operations for NHS England North Midlands, said, “This is an innovative and ambitious programme to improve cancer and end of life care services for people in Staffordshire. Work will continue, but it is important that we take all reasonable steps to ensure that the end result will deliver the effective and reliable services patients want, as well as value for money.”

Anti-privatisation campaigners have warned that the contract risked repeating the mistakes of the Cambridgeshire deal and said that they hoped the process would be halted completely. Gail Pearson, a member of the campaign groups Keep Our NHS Public and Cancer Not for Profit, said, “In the interests of patients we now hope the whole thing will be scrapped completely. Financial problems were behind the collapse in Cambridge, and, given the soaring demand for cancer care from this fixed price contract, surely that will apply here.”

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About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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