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16.11.16

UnitingCare fiasco means CCG must ‘come clean’ about service damage, PAC warns

Older people’s and adult community services are likely to suffer following the collapse of the contract between Cambridge and Peterborough CCG and UnitingCare, the Public Accounts Committee (PAC) has warned in a report today.

Describing the handling of the contact as a “catastrophic failure”, the PAC set out urgent recommendations to address the NHS’s lack of commercial skills and has called upon NHS England to improve its supervision of contracting agreements.

UnitingCare, a partnership between Cambridgeshire and Peterborough NHS FT and Cambridge University Hospitals NHS FT, signed an £800m deal to deliver older people’s services in 2014. It was intended to run for five years, but was cancelled the following December because it turned out to be financially unsustainable.

The collapse of the deal cost the two trusts and the CCG at least £16m and has reduced the money now available to provide patient services in the region.

Meg Hillier MP, chair of the PAC, said: “It beggars belief that a contract of such vital importance to patients should be handled with such incompetence.

“The deal went ahead without parties agreeing on what would be provided and at what price – a failure of business acumen that would embarrass a child in a sweet shop, and one with far more serious consequences.

“Services for patients are likely to suffer and we will be expecting the CCG to come clean about precisely how much damage has been done in terms of future service provision and finances.”

Hillier added that while she understood the need for service providers to be innovative with their approaches given the current NHS budget, the PAC believed that the CCG’s decision to outsource services to the lowest bidder without due care for patients and the taxpayer was “grossly irresponsible” and unacceptable.

There is now concern within the PAC that the UnitingCare fiasco reflects weaknesses in the NHS which could result in other ill-affordable and damaging errors, such as local initiatives proposed as part of STPs which are seen as key to NHS reform.

“The PAC has previously called for measures to improve commercial skills in the NHS and once again we have seen the effects of what appear to be gaping holes in its abilities,” said a member of the committee, Karin Smyth MP.

“There have now been multiple reviews prompted by this project, which will come at a cost, and the CCG continues to rely on consultants – at the time we took evidence, it had lined up an £800,000 contract for advice on how to improve its financial situation.

“NHS leaders need to address this lack of commercial expertise as a matter of urgency to ensure no more taxpayers’ money is wasted on ventures that, while well-intentioned, are simply not fit for purpose.”

The PAC has called on Cambridge and Peterborough CCG to explain in its STP the impact of the UnitingCare contract failure on its ability to deliver health care services.

The committee also warned other local CCGs to take responsibility for designing more integrated healthcare systems themselves, rather than abdicating responsibility to unaccountable providers.

Separately, NHS England was advised to set out for CCGs the minimum steps needed to assess “the realism and viability” of bids for service provider contracts, to introduce safeguards so contracts cannot start unless these steps have been followed, and to report back to the PAC by April 2017 on the action taken to improve local NHS bodies’ commercial skills.

An NHS England spokesman said: "The hospitals, GPs and community health teams in Cambridgeshire have clearly now learnt from their mistakes over this process, and nationally the NHS has now issued proper safeguards to ensure other local areas don't repeat their approach."

Tracy Dowling, Chief Officer at Cambridge and Peterborough CCG, explained that there have been a number of published reviews into the contract failure which acknowledged the complexity of the procurement, and the CCG is continuing to develop services along the lines of the UnitingCare model.

However, the CCG has accepted the findings of all of the reviews and Dowling offered her assurance that maintaining continuity of services for patients remains a priority for all parties involved.  

“We will fully consider the recommendations in today’s Public Accounts Committee report to ensure that we have taken account of all possible learning from all the reviews,” Dowling said.

“In common with other areas, we are now working with our NHS and Local Authority partners to develop a Sustainability and Transformation Plan to address the challenges of a growing and aging population. This needs to be a robust plan owned by all the organisations providing health and care locally which will allow us to meet our ambitions for health and care and to make services financially sustainable," she concluded.

(Image: Addenbrooke's Hospital in Cambridge c. Chris Radburn PA Images)

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