NHS: “Unacceptable” Firm Wins Contract

Despite its work being condemned as “entirely unacceptable” just last year, outsourcing firm Capita is now leading the development of an NHS area in the north of England. Working with the private firm is US healthcare insurer Centene Corporation, sparking further fears that the NHS is moving closer to an Americanised private health service.

Sustained Damage

As part of the Tory five-year health plan the UK was divided into 44 health care areas known as Sustainability and Transformation Partnerships.

These STPs were created to look at NHS management and funding in an effort to cut costs by £5bn a year but they’ve been riddled with faults and accusations. GP magazine Pulse revealed that STPs had spent an estimated £21.2m outsourcing work because they didn’t have the in-house expertise, despite that being the reason they exist.

Now the Nottingham and Nottinghamshire STP planning effort has been contracted for £2.7m to Capita, a London-based professional services firm lambasted for its previous foray into NHS management.

In 2016 Capita was handed a £700m contract for providing GPs with support services. GPs described Capita’s management as a “shambles” with delays in medical note transfers and shortages in basic equipment.

Coventry North West MP Geoffrey Robinson said the “terrible service” ended up costing more than the previous service because Capita was in no way prepared for the job and didn’t have “commitment” to providing a service.

Bad Track Record

Capita’s poor NHS history goes back to June 2014, when five of eight Liverpool NHS Trusts pulled out three years into a seven-year Capita contract over quality concerns. West London Mental Health Trust followed in September 2014, cancelling its contract because of Capita’s inability to meet targets.

Two other trusts quit their Capita contracts at the same time. Despite these clear warning sirens, Capita was awarded the four-year contract making it the sole provider of admin services for GPs, dentists and opticians in the UK in June 2015.

An undercover investigation by the Daily Telegraph in 2015 revealed that locum agencies owned by Capita were charging some hospitals up to 49% more than others, as well as giving false details about the company.

Though Health Secretary Jeremy Hunt (left) publicly chastised the firms and others trying to make large profits at the NHS’s expense, that hasn’t changed Capita’s ability to win contracts and doctors are understandably worried.

An anonymous Nottingham GP told the British Medical Association that “GPs are not very happy about Capita being involved in any way with STPs. Capita’s track record… has been shocking. It is unbelievable that Capita continue to get NHS contracts, despite ongoing failings”.

Americans Step In

While Capita is the lead name on the contract it will be handing over large parts of it to US health insurer Centene. Their mission is to get Nottingham and Northamptonshire from an STP to an ACS – an accountable care system – which will take control of the area’s budgets and commissioning.

Accountable care systems are part of the Government’s plans to fulfill NHS cuts, pledges and improvements. Centene’s involvement has been ascribed to NHS England’s demand for organisations with international links and experience in major healthcare changes.

Centene previously worked in Spain on the Alzira healthcare model, named for the town it was created in.

The Alzira model is famous for its 90% patient satisfaction rates. It works through capitation, where healthcare providers are paid a set amount for each person enrolled under their practice or care, whether they are sick or not.

Because they are paid per head rather than for the amount of time and care each person requires, there’s an incentive to keep patients healthy.

The result is that physicians consider treatment costs each day and focus on preventative rather than reactionary health care.

The model from the Alzira hospital (above) in Valencia is based on a private finance initiative, which funds public projects with private capital. The UK already has initiatives but Centene’s involvement has raised fears that more extensive privatisation is planned.

BMA East Midlands regional council chair Peter Holden explained that neither Capita nor Centene were a welcome addition to the health service.

“Capita’s reputation among doctors is frankly appalling – and it’s even more worrying that they are allowed to sub-contract further and that’s compounded by the fact that the firm in question is involved in private healthcare.” Holden went on to call the decision “a real kick in the teeth for the profession”. He and other healthcare professionals aren’t confident that Capita will be changing its ways or the NHS for the better any time soon.

 

by Jo Davey

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