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Amplitude Clinical Outcomes

Outsourced services are not being monitored or enforced by Clinical Commissioning Groups

After having outsourced services to private providers, Clinical Commissioning Groups (CCGs) are failing to monitor or enforce those contracts, according to a newly released report.

CHPI, the Centre for Health and the Public Interest, sent 211 Freedom of Information (FOI) requests to CCGs, revealing that 60% of those responding, 181, never recorded the number of site inspections they did on outsourced services. They were further unable to document the number that they did undertake and alarmingly, 12% of respondents indicated that they didn’t do any inspections whatsoever.

16% of Clinical Commissioning Groups’ budget goes to private sector

At the moment, 16% of CCGs’ care budgets are allocated to the private sector and they monitor, manage and enforce approximately 15,000 private provider contracts.

As indicated in the report, there is an increasing number of privately backed and multinational companies that have been awarded contracts and to date, only seven have had their contracts terminated for what is considered to be a failing.

CCGs not willing to enforce private sector

According to CHPI, CCGs appear to be reluctant to enforce their private sector contracts and the reports instituted by the CHPI also only found 16 Care Commissioning Groups had financially sanctioned any of their providers for poor performance.

In a 2013 study of CCGs it was found that they were not willing to enforce contractual terms in the fear of making the financial circumstances of their providers worse.

This report states that the reason a great number of Care Commissioning Groups are unable to respond to questions in regards to outsourcing is due to complex arrangements in dealing with them.

CCGs have statutory accountabilities

As the contracting entities, CCGs have statutory accountabilities but a large portion of those CCGs have given the monitoring contract function to Commissioning Support Units, CSUs. Amongst all CSUs there are 8,500 people on staff and at the moment are part of the National Health Service England. Even so, the government has aimed for April 2016 as a target date for those entities to go private.

The Centre for Health and the Public Interest is asking the National Health Service to rethink their intention to privatise the monitoring of NHS contracts. It is CHPI’s contention that as the statutory regulating bodies accountable for the enforcement of contracts between the private sector and the NHS, CCGs should be held accountable if something goes wrong, and not the CSUs. This problem will only get worse if privatisation of CSUs should occur.

Response and defence of report

Further recommended on the report is that an audit of Care Commissioning Groups should be commissioned by the NHS in terms of the CCGs’ ability to monitor and/or manage non-NHS contracts with private providers.

As co-author of the report, Colin Leys believes that the NHS is not well equipped to ensure that safe and high quality care will be provided by privately owned outsourced providers.

Jeremy Hunt responded to a question posed by parliament in terms of the use of providers that are private within the National Health Service. He states that the NHS pursues competition to provide quality care with a national tariff system that is fixed.

Hunt further states that the NHS’ neutral stance on who should be the provider of services ensures that patients will get the best services possible as well as the best outcomes. He says that decisions are made by clinicians on a local level who are felt to be best qualified to speak on behalf of the patients they treat.

Image labelled for reuse on Google Search Engine (3rd November 2015)

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