A wrangle over the future of a doctors’ surgery in Brighton is to examined by councillors at a special meeting this week.
NHS Sussex put the contract for the Wellsbourne surgery, in Whitehawk, out to tender and earlier this year announced an intention to award the contract to One Medical Group, a company based in Leeds.
The news prompted outrage among staff at the Wellsbourne practice, their patients and their many supporters across the area.
Much of this was driven by the way that the current team at the surgery – the Wellsbourne Healthcare Community Interest Company (CIC) – had stepped in when a previous contractor pulled out.
And it was further fuelled by the knowledge of the ways in which the current team has gone above and beyond merely fulfilling its contractual responsibilities to care for the patient population.
The CIC appealed against the NHS Sussex decision in March and made further representations in the months that followed.
It asked the Independent Patient Choice and Procurement Panel to consider the concerns that it had raised and the tendering process was paused.
The panel published its advice on Wednesday 23 July and that advice has been included in the papers going before Brighton and Hove City Council’s Health Overview and Scrutiny Committee on Friday (26 September).
The recommendation was that NHS Sussex, the integrated care board (ICB) for the county, go back to an early step in the process by publishing a new contract notice and invitation to tender (ITT).
NHS Sussex has also commissioned an external review.
The panel said that NHS Sussex had breached the rules governing the tendering process. It had conducted the evaluation and scoring process differently to the way that it had told the CIC and, as a result, did not act transparently and fairly.
The panel also found that NHS Sussex did not provide adequate information to enable the bidders to work out the financial aspects fairly.
Finally, the panel found that NHS Sussex, in its evaluation and scoring of Wellsbourne’s financial proposal, breached rules that require the ICB to keep a record of the reasons for its decisions.
The panel said: “The panel’s view is that Sussex ICB’s breaches of the PSR (Provider Selection Regime) regulations are sufficiently serious to have had a material effect on its selection of a provider.
“This is particularly the case in relation to the Sussex ICB’s provision of information about LCSs (locally commissioned services) in the provider selection process and its request for bidders’ estimated income from delivering LCSs.
“The panel’s advice to Sussex ICB is that it returns to an earlier step in the provider selection process, namely the publication of a new contract notice and issuance of ITT documentation suitably revised to address the issues identified by the panel in this review.
“This will allow a new provider selection process to take place that addresses all of the issues identified by the panel in this report.
“The panel also recommends that Sussex ICB ensures that, in future, sufficiently detailed notes are kept of moderation meeting discussions so that bidders, internal review panels and the panel can follow the reasoning of those involved in decision-making.”
The council’s Health Overview and Scrutiny Committee is due to meet at Hove Town Hall at 2pm on Friday (26 September). The meeting is scheduled to be webcast.
So we have Sussex NHS or the ICB failing to do basic tasks such as maintaining a level playing field for tendering, ensuring fair competition. Subsequently they have not even kept minutes of meetings or a written record of their decision making process. This has now generated more expense to the Public purse. Has anyone been held to account? This is the sort of failing that makes one despair. This situation has been created by someone not doing the job for which they were recruited and well paid for. Can we expect any repercussions? Don’t expect any answers.
The repercussions are procedural correction, Ann. Arguably, the most important repercussion.
The question is why are “procedural corrections” required? The most important repercussion is that someone did not or was incapable of doing their job properly. All this time they were drawing down a salary funded by the taxpayer and more time and money is spent dealing with their incompetence. What is the comeback for the Public purse? Might as well put a lingerie specialist in charge of PPE for COVID!
How’d you know that it wasn’t a structural issue, oversight, or contested interpretation of process? Either way, that is a false analogy.
Well they are all public bodies this week should be informed. An “oversight” is a word for mistake. If it is a structural issue then whoever devised and implemented the system is culpable. It is not a “contested interpretation of process” simply because the outcome is damning and someone has been derelict in their duties. You often speak sense and are commendably reasonable on these forums but I fail to understand why you cannot attribute blame where it is due. It is this sort of prevarication and evasion that promulgates inefficiency and infuriates the general public. Is it little wonder that snake-oil salesmen are becoming dangerously popular in politics?
Ann, I’m not saying there should be no accountability. What I pushed back on was your framing, that this must be down to one person’s incompetence. That’s a strawman of what I actually said. Oversight, structural design, or unclear rules are all real possibilities here, and the regulator’s role is to correct those. If we only ever personalise failings, we risk ignoring how the system itself can (and should) be fixed.
It was a good stay of execution, but we may still lose Wellsbourne to this process. There’s a debate to be had if there’s no issue, or in this case, a vast improvement, with the surgery as is – should it be subjected to a contract because an arbitrary amount of time has passed?
As a patient of Wellsbourne, I am terrified of having to see a Dr that is working for a private profit making company. How can you trust the recommendations they make when profit is involved? My experience with private dentists and vet is one of constantly upselling, referring on for further profit. How have we got this privatisation almost by stealth ……horrendous move
Absolutely reasonable take to have, considering the circumstances. Put it this way, and hopefully it gives you a bit of comfort. Pharmacies work on the private model and have been for years, and in my experience, they constantly fight back against corporate to ensure that what they do is for the patient, not the bottom line.
GPs don’t have the mechanism for upselling, really in the same way. Medicine prices are strictly controlled via the BNF, so there’s no price gouging. Their KPIs tend to be focused on seeing people as quickly as possible, and reducing the amount they prescribe, and this time of year, getting as many payments from flu jabs as possible – which…the financial incentive also fits what we would like to see to protect the health of society anyway, so aligns well.
A for-profit would likely target efficiencies, reducing how long you see a doctor, hiring cheaper staff, reducing opening hours, and cutting back on extra bits like community-based work. The actual healthcare delivered, though? I think doctors become doctors for a reason, even if a corporation makes it difficult.
Ann makes an excellent point.
Ben – if private contractors are so efficient, can you please provide some background on the performance of One Medical Group to date as I understand they operate practices elsewhere in the UK? If you can confirm they have an exemplary record perhaps this may have influenced the decision of NHS Sussex, despite their lack of following the correct procedure.
On ensuring OMG maximise profits? They say it verbatim in their HMRC annual report, Craig, then back it up with the finances, also speaking in detail about they push efficiency.
I think you are right that they would use this to argue their case. It’s a solid argument pragmatically speaking. But, in my opinion, a GP is not just a revolving door.
The procurement design and scoring are what make it harder for CICs to compete on equal terms, in my opinion, and certainly, an aspect should be explored. The loss of Healthwatch is felt deeply in tackling this issue.