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  • RCGP calls for an end to the ‘vicious cycle’ of unfair funding for GP training

    RCGP calls for an end to the ‘vicious cycle’ of unfair funding for GP training

    Tuesday, 10 July 2018 09:39
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  • Scotland update Golden Hello arrangements for GPs

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  • Extra £20m funding will go hand-in-hand with a new 10-year plan for the NHS

    Extra £20m funding will go hand-in-hand with a new 10-year plan for the NHS

    Monday, 18 June 2018 17:31

a gp imageMay 21 2018 

NHS England and Capita’s handling of primary care support services has been criticised in an official report.

The National Audit Office has published a review saying that “NHS England and Capita misunderstood the risks in outsourcing primary care support services resulting in services to 39,000 GPs, dentists, opticians and pharmacists that were a long way below an acceptable standard.”

While there has been some improvement in Capita’s performance, “widespread failures are still being experienced by primary care practitioners.”

Capita is contracted to provide administrative and back-office support via Primary Care Support England (PCSE). Services include: 

  • administering payments to GP practices, opticians and pharmacies;
  • administering the pensions of GPs;
  • administering entry and changes to national performers lists;
  • ordering supplies;
  • moving patients’ medical records and processing patient registrations.

NHS England had agreed a £339 million contract with Capita to run existing support services for primary care and to transform the services. However, this was high risk, said the NAO, as it relied on 35% savings having to be made in the first couple of years of the contract at a loss of £34 million to Capita, which would then recoup the money later.

“NHS England has made savings, in line with expectations, of £60 million in the first two years of the contract, as the financial risk of increased costs sits with Capita who have made a £125 million loss over this period,” said the NAO. NHS England has penalised Capita by withholding a further £5.3 million but may have to compensate primary care contractors with £3 million.

The BMA has been raising a number of concerns including late payments being made by Capita, and problems around transferring patient records. Following the publication of the NAO report, the BMA said it has written to NHS Chief Executive Simon Stevens urging him to lay out an action plan showing how he intends to address the many issues highlighted in the report.

It has also launched an online tool for its GP members to pledge their support for a properly-run PCSE service and to share their own experiences of failures with the system.

Dr Richard Vautrey, BMA GP committee England chair, said: “This damning report lays bare the scale of the failures impacting patients, services and GPs due to this poorly thought-out and woefully-run programme delivered by Capita.

“That NHS England ignored the BMA’s serious concerns and went ahead with massive cost-cutting by commissioning Capita to take charge of PCSE – with the expectation that they’d have to strip resources to the bone – with no thought of the consequences is nothing short of scandalous. 

“It’s clear that Capita prioritised money over service and were incentivised by the contract awarded by NHS England to close support offices and cut staff as quickly as possible regardless of the problems that were quickly developing.

“While NHS England may have hit its financial targets, the two years of chaos experienced in practices up and down the country by both patients and GPs – whether this is to do with records, supplies or payments – sits completely at odds with this definition of ‘success’. It’s GPs and patients who have paid the price for this.

For the RCGP, Professor Helen Stokes Lampard said: “This is a damning but fair account that highlights how NHS contracts have been awarded to private companies, such as Capita, for work that is substantially more complex than had been assumed, and that they have failed to deliver effectively as a result – with GPs, our teams and our patients suffering the consequences.

“The long list of failures made by Capita have been incredibly frustrating for GPs and our teams, and we are still dealing with the fallout - including a significant additional administrative burden – at a time when practices are already working under intense resource and workforce pressures.

“Moving forward, lessons must be learnt by the NHS, but also by companies bidding for NHS contracts who need to realise that by taking on this work, patient care and patient safety lies in their hands. Patient safety must always be the number one priority when awarding private companies contracts for any work in the health service.”

Links:
NAO announcement     
NAO ‘NHS England’s management of the primary care support services contract with Capita’ report. May 17 2018          
RCGP comment            
BMA comment 

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