Commissioning

UnitingCare probe a ‘very important moment’ for NHS – Stevens

NHS England will publish the results of its investigation into the major five-year £800m UnitingCare partnership deal, which collapsed after just eight months in December, in the next six to eight weeks to ensure the rest of the NHS can learn from the findings.

The organisation’s chief executive, Simon Stevens, said this is “a very important moment for the whole of the NHS” to learn from the mistakes in the deal, though he also gave assurances that there will be no disruption to patient services.

“I expect we will [publish the results] within six to eight weeks because there needs to be a quick, targeted, thorough piece of work that everybody else can then pay attention to,” he said during a Commons Public Accounts Committee inquiry this week.

Committee chair Meg Hillier MP said the National Audit Office has also received a letter asking for an inquiry.

The failure followed one of the biggest tendering exercised in the health service, when an NHS consortium of Cambridgeshire & Peterborough NHS FT (CPFT) with Cambridge University Hospitals NHS FT (CUFHT) were chosen to improve older people’s healthcare and adult community services in the region.

It began running services in April 2015, but broke down in early December after the partnership declared the deal was no longer financially sustainable. Cambridge and Peterborough CCG has since taken over services.

Grilling life sciences minister George Freeman MP on this subject during a Commons debate on Monday, Labour MP Daniel Zeichner said: “When health leaders in Cambridgeshire said they wanted to create an integrated service for older people that would focus on prevention, it was a worthy aim, albeit polluted by the need for a competitive tender, insisted upon by the Health & Social Care Act 2012.

“When the contract was finally signed with NHS providers, it should have been the start of a new way to provide care, so what went wrong? That is what I want to quiz the Minister on tonight, because the failure of this contract matters way beyond Cambridgeshire, and it has rightly attracted national attention.”

Zeichner then went on to describe the earlier days of the region’s healthcare prior to the contract, and argued that, when the deal crumbled, there was damage amounted from procurement process costs right down to the impact on staff.

“Having given a brief outline, let me come to the further questions that I hope the minister will be able to help us with,” he continued.

“First, on the flurry of investigations being announced, although it is right that individual organisations will want to look at their role, there is a danger not only of duplication but of exactly the kind of fragmentation that has caused such problems already.

“Given the conflict of interest within NHS England that I have already described, would it not be better to have a genuinely independent review carried out by the National Audit Office—a review in which we could all have confidence?”

Responding to Zeichner’s extensive questioning, Freeman said “we should let the NHS complete that process” [of reviewing the terminated contract] and, once reports are published, ensure ministers are briefed on all conclusions.

“The issue is contractual and relates to a dispute between the parties about liabilities in the contract. As I have said, I do not want to prejudge the ongoing investigations, the point of which is to work out what should have been done differently. I can absolutely reassure [you] and the House that we are hungry to learn any lessons from that commissioning experience,” the minister said.

“We need novel commissioning. We need commissioners around the country to look into different ways of commissioning the reforms to our integration of health and care, and lessons need to be learned when it goes wrong. I emphasise that this was a contract between the parties. As I have said, the department is looking forward to the reviews and wants to hear the lessons that others can learn.”

At the CCG’s governing body meeting last week, it gave this rationale for ending the contractual arrangements: “The model was developed by UnitingCare with a five to seven year expectation of cost, including upfront investment to be supported by the partners in the consortia, CUHFT and CPFT. Since the procurement process concluded in July 2014, the local health system landscape has changed substantially. Partners in the health system did act to provide short term support but the arrangement was not sustainable, and it was agreed that the contract had to be terminated.”

(Top image c. Chris Radburn)