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Independents' Day

CCGs embrace advice from private firms

Exclusive: Leading private companies are already advising scores of CCGs on how to spend NHS cash, as the Government’s new commissioning marketplace takes shape.

PricewaterhouseCoopers (PwC) revealed this week it is now working with around 100 CCGs, while KPMG is working with 50 CCGs and Capita around 40.

The companies are providing a mixture of short-term support to CCGs and commissioning support units on areas such as governance and authorisation, alongside longer-term advice on how to meet the daunting £20bn efficiency challenge set by the Government’s QIPP agenda.

Pulse reported last year that private consultancy firm McKinsey had been enlisted by dozens of CCGs to advise on QIPP, budget-holding and governance, although McKinsey this week declined to comment. A Pulse investigation in January found four in 10 CCGs had begun to seek advice from the private sector.

Speaking at a Westminster Forum event last week, Tim Rideout, associate at KPMG, said the expertise provided by the private sector was vital as CCGs ‘do not have the capacity and capability to commission in an effective way’. He said: ‘The key message that comes from CCGs is that commissioning support is absolutely essential if they are going to succeed.’

Dr Jonathan Steel, senior clinical consultant to PwC and a GP in Uley, Gloucestershire, said: ‘We’re seeing the more advanced CCGs asking for help with service redesign.’

Liz Jones, director of commissioning services at Capita, told Pulse the firm was helping CCGs on issues ranging from helping them set up their boards to meeting QIPP targets. 

Ms Jones said: ‘What we’re seeing now is a fair number of [CCGs] starting to move beyond the authorisation hurdle. QIPP still needs to be delivered, can we bring a fresh pair of eyes to what they’ve been doing, [look at] why have they struggled to meet the numbers, what have they missed out, what could they do differently?’

Dr Michael Dixon, interim president of NHS Clinical Commissioners, said the dynamics of commissioning support was ‘entirely a master-servant issue’.

But he added: ‘Commissioners need to be very much awake in terms of [judging] when commissioning support is just that, and when it begins to infringe upon their ability to make a decision.’

Dr Louise Irvine, a GP in Lewisham, South east London, said she was ‘very concerned’ that private companies were being handed ‘enormous power and influence over commissioning’.

Dr Irvine said: ‘It is not the small friendly image of commissioning by your local GP that was promoted in the white paper.’

Readers' comments (7)

  • What is the basis for the commissioning 'support'? Is it being provided free on a public service basis? Is it being paid for (from Treasury-provided public funding) on a contractual basis? What are the terms of any such contracts, dishing out public money? Doeas the public have right of access to that information? Will those providing advice to the contractors be formally and legally precluded from representing the interests of actual or potential contractees? Is the potential for conflict of (public)interest directly consideredWho will take legal responsibility if advice for a commissioning decision proves to be ill-considered, negligent or wrong?

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  • From my understanding of the Health & Social care Act 2012; Clinical Commissioning Groups and the constituent GP practices (as a collective) will have full legal responsibilities for “commissioning” services. Even if they sub-contract advice or actual support to the CSU and/or private companies, the buck stops with them. If CCGs do not carry out due diligence or have systems in place to prevent conflicts of interests then the CCGs will be held responsible and legally liable. And by default, since CCGs are membership organisations- the GP member practices are accountable for this.

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  • The CCGs are not statutory bodies yet. The umbrella PCTs were basically instructed (forced?) to commission the services of these companies.

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  • The wider agenda is the contraction of the public sector, so whether 'required' or engineered through reduction in public sector capacity, the result is the same.
    The alacrity with which some seized the possibility of being 'in charge' of commissioning health services is thrown into sharp relief against the reality of what that might actually mean in practice ( no pun intended).

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  • You have to wonder where all this fabulous knowledge possessed by PWC, KPMG et al comes from.

    My experience of working with consultants is that they are mainly very young and err....inexperienced but have lots of University gained skills. Apart from that they are just basically feeding back to you what you have already said...but in a more polished...expensive way.

    PCT Finance Manager

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  • CCG's have a very large amount of work to achieve and from what we have seen do need the help and support of external consultants. I agree with some of your comments and reservations however not all consultants are err young so to speak and some of us have a wealth of experience especially in relation to Governance, Quality and probity. Value for money is the question to be asked and also effectiveness glad to help and discuss

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  • The fight to save our NHS is vital, and must happen now

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