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CCGs must avoid private provider bullying tactics

CCGs must avoid private provider bullying tactics

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Urgent changes are needed to ensure that CCGs do not repeat the mistakes of primary care trusts (PCTs), healthcare leaders have warned. 

Late last week it was revealed that private out of hours provider Serco had falsified performance data on 252 occasions, using “bullying tactics” to silence whistleblowers. 

The primary care trust who contracted Serco did not demonstrate “appropriate skills” to deal with the problem, according to the Public Accounts Committee, but healthcare leaders claim clinical commissioners will avoid such situations. 

Kernow CCG, who took over the contract, have already received £85,000 in returned bonus payments

Dr James Kingsland believes that clinical commissioning groups have the potential to avoid such situations because they have a better understanding of the business. 

The national clinical lead for NHS Clinical Commissioners said: “PCTs didn’t fully understand the nature of general practice and how it was delivered. When they took over responsibility for GP out of hours they took a viewpoint that it was a system to be delivered just like any other.

“The whole idea of the creation of CCGs was to have a much more focused outlook and a clinical thought process in developing services.”  

‘Cheapest provider’

In Cornwall, Serco “consistently failed” to have enough staff to fill all of the out of hours clinic and car shifts. 

The introduction of NHS Pathways in 2012 caused the quality of care to plummet further, with the provider underestimating how many staff were needed to operate the telephone triage service. 

Serco was the only bidder which claimed it could afford to provide out of hours service at the cost ceiling set by the primary care trust. 

Dr Michael Dixon, chair of the NHS Alliance argued that through their day-to-day contact with patients, general practitioners have far better feedback on services than PCTs ever could. 

He said: “We have far better intelligence on how services are doing. If there are issues, very quickly local clinicians find out.

“It means that we’re in a better place now. We’ve learned that we need to be wary around bids that propose to do the job. The best provider is not always necessarily the cheapest one.”

Andrew Abbott, director of operations for NHS Kernow CCG, said: “We are not naïve in dealing with private providers. I and many of my staff have a background in the private sector so we understand the motivations of private companies which are, naturally, different to those of the NHS.

“However I’m confident that Serco and all providers of NHS services have at the forefront a desire to deliver a great service to patients.”

But National Association of Primary Care (NAPC) chairman Dr Charles Alessi said the situation has been played out “repeatedly” and that the new commissioning landscape must change. 

Dr Alessi said: “The NHS has not been very skilled at actively monitoring contracts in the past. The new world needs this to change and change quickly. 

“We tend not to mention the fact that even in services totally within the NHS, the levels of data divergence between commissioners and providers can be significant.” 

NHS Kernow has installed enhanced monitoring of the urgent care system, so that all performance data received from the company is analysed before being confirmed. 

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