27.05.15
Pathology Partnership deficit three times higher than expected
The Pathology Partnership (tPP), a joint venture of six NHS trusts in the east of England, has recorded a deficit of £4.9m in its first year – more than three times the amount anticipated.
In a paper to be presented at Hinchingbrooke Health Care NHS Trust’s board this week, the trust’s chief finance officer Ian O’Connor says the tPP plan for the 11-month operating period to 31 March 2015 was for a deficit of £1.1m, while the final outturn for 2014-15 was a deficit of £4.9m.
The tPP service is hosted by Cambridge University Hospital Foundation Trust (CUHFT) with the contract coming into force on 1 May 2014. It was expected that tPP would transform and modernise pathology services for hospitals and GP practices initially across Cambridgeshire, Suffolk, Essex and Hertfordshire.
However, Williamson’s paper outlines a “number of service issues impacting Hinchingbrooke as a customer of tPP”.
For instance, there has been a reduction in the test turnaround times, which is further compounded by the lack of performance data.
Additionally, CUHFT is not reporting COSD (Cancer Outcomes and Services Dataset) data to Public Health England. Williamson noted: “This data is a contractual requirement for the trust [Hinchingbrooke] and is outside of its control.”
There have also been issues with Beaker (the CUHFT hub laboratory information management system used by tPP) not linking parent and child tests – the GP or clinician requests a test and the results of that test indicate that further tests are necessary; Beaker reports results for each test as it is completed but does not link these to the original request.
“This will require either a significant modification to Beaker software (at considerable cost) or some form of ‘middleware’ to do the linking and reporting back to requester,” added Williamson.
On top of this, there are issues with the CCG service. For instance, a CCG contract query notice has been issued to tPP and there are weekly monitoring meetings in place to track recovery.
Williamson added that CCGs are focused on contract performance rather than resolving funding gaps and volume uplifts that tPP requires, ensuring it is getting paid for activity undertaken. Also, in the last year, pay costs were 5% higher due to the use of agency to fill vacant posts.
He said a full analysis from tPP of the “causal factors for the increased deficit has been requested”. Hinchingbrooke has been required to take it share of the deficit totalling £243,000.
“Over the five years of the CCG contract the pathology service will cost £2m more than signed off in the Investment Plan if the current level of spending continues and therefore the anticipated share of surplus amounting to £658,000 over that period will not be realised,” Williamson concluded.
NHE has asked tPP for more information about the causes of the increased deficit and what measures are being put in place to reduce this in the future, but at the time of publication had not received a reply.
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