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STPs and ICSs spend nearly £27m on private agencies, investigation reveals


By Léa Legraien
Reporter
17 December 2018

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NHS bodies have spent millions on private companies, an investigation has revealed.

A freedom of information (FOI) request sent to all 44 STPs and ICSs by the BMA found that £26.7m has been paid out on private consultancy services. The FOI included new information received from 30 of the 44 STPs, as well as existing information from nine.

The findings were published in the BMA’s magazine The Doctor.

Millions of pounds

The FOI showed that most of the £26.7m was spent on consultancy firms tasked with looking at areas including ‘reviewing demand and capacity’, ‘supporting sustainability’ and ‘reviewing hospital services’, the BMA said.

Among the STPs and ICSs behind the biggest pay-outs, the BMA listed the following organisations:

  • Kent and Medway STP: £6.2m paid to Carnall Farrar.
  • South-East London STP: spent £3.3m on PricewaterhouseCoopers (PwC).
  • South Yorkshire and Bassetlaw STP: handed £1m to Deloitte.
  • Cheshire and Merseyside STP: paid out £821,000 to KPMG.
  • Coast, Humber and Vale STP: bought £448,000 worth of services from PwC.

In addition, the FOI revealed that 565 new non-clinical jobs were created across the country – at an annual cost of around £33m – to reorganise healthcare services. This compares to 150 in June 2017, according to the BMA.

BMA council chair Dr Chaand Nagpaul chair said: ‘Given the perilous state of NHS finances and patients suffering delays for essential services, it is utterly unacceptable to see so much money flowing away from patient care to private consultancy firms.

‘For many frontline staff, so used to seeing a lack of investment in workforce, equipment and buildings in their workplaces, this level of spending on private consultancy firms will be extremely difficult to comprehend.’

Lack of legislation

STPs and ICSs are not legal entities, and are therefore not subject to the duty of transparency that applies to other NHS organisations.

The BMA said the lack of legislation and accountability have raised questions around the legitimacy of integrated care in the NHS.

Dr Nagpaul said: ‘New structures should be backed by statute, have proper transparency and should only be formed when proper, genuine clinical engagement has taken place.’

Commenting on the findings, University of Manchester professor of health policy and management Kieran Walshe said: ‘[Lack of governance] remains a real area of weakness – they are not statutory bodies and don’t have to have a named officer dealing with FOIs for example.

‘That is a concern about the accountability and governance and the fact that STPs, unlike NHS trusts, don’t have any rules about governance arrangements.’

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