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A faulty production line

GPC demands practices be compensated for 'systematic failure' of support services

The GPC has told NHS managers that every practice should be compensated for the significant extra workload they have had to take on as a result of the ‘systematic failure’ stemming from the handover of primary care support services to the private provider Capita. 

The GPC sent a letter to NHS England most senior management to highlight the ‘serious and systemic failure’ of the relaunched primary care support service, for which it is ’ultimately responsible’.

Capita has said that they have introduced new procedures in a bid to alleviate the problems for practices.

Pulse has written extensively about the problems with Primary Care Support England, which has seen practices accumulating piles of uncollected patient records, missing payments, and left without vital practice supplies.

The GPC has raised these issues with Capita, but the letter states that interim solutions have heaped more workload and costs on practices and things have not improved ‘despite reassurances’ made weeks ago.

In the letter, GPC chair Dr Chaand Nagpaul writes the new service has undermined a ‘reliable and trusted NHS service with the explicit intent of making significant financial savings’ and the result has been further burden on already hard-pressed practices.

Dr Nagpaul writes: ’’I write to highlight the significant concerns of the BMA’s GP committee and the wider GP population with the systemic failure of the services provided by primary care support England under contract to Capita, having received a multitude of serious complaints from practices and LMCs.

’While these have been discussed with Capita, the scale of the problem means we need to highlight this at the most senior level as NHS England is ultimately responsible.’

The GPC chair says that as a result of the problems from this transfer, NHS England must ensure: ‘Every practice should receive recurrent recompense for the extra workload related to the new Capita services, in addition to compensation for increased workload and inconvenience caused by the unsatisfactory introduction of these services.’

He calls on them to demonstrate:

  • exactly what is being done to resolve and stabilise the service;
  • that no further plans will be implemented until they have been thoroughly tested, and proved to be safe, but also acceptable to end users;
  • sufficient numbers of adequately trained staff are available (halting office closure plans if required);
  • lessons will be learnt, by altering the service specification with Capita and by providing additional funding support for practices;
  • any current or future PMS reviews should take into account the increased workload when deciding on appropriate levels of funding;
  • any governance breaches should be investigated and NHS England must indemnify GPs who have acted reasonably, but find through no fault of their own, breaches of any CQC or information governance issues as a result of these changes.

Pulse asked NHS England if they intended to take action when the problems were first revealed, and a spokesperson said they had tasked Capita with making improvements to make services ‘more efficient, more reliable and ultimately better for GP practices.’

They added: ‘We will continue to work closely with Capita to review ongoing progress and investigate feedback from users as this new approach is implemented.’

When Pulse first put concerns about delays raised by GPs to Capita, a spokesperson said after an intial ‘pause’ to collections to at new national courier service, they have ‘introduced a secure, weekly collection service for medical records for all GP practices across England.

‘All of our courier service staff have mandatory ID and nothing should be handed over unless ID is presented.’

A Capita spokesperson told Pulse: ’We are continuing to work closely with NHS England and proactively engaging key stakeholders, including the GPC and LMCs, so we can continue to refine and improve the service going forward.’

Pulse has approached NHS England for comment on the GPC’s letter.

The problems with the outsourced support services

paperwork, patient notes, patient records, envelope - online

paperwork, patient notes, patient records, envelope - online

Source: Julian Claxton

NHS England announced it intended to outsource the national primary care support services contract to a single provider in 2014, in a bid to save 40% from its £100m a year annual budget.

And Pulse has followed the progress of the move, first revealing the ‘significant and sustained disruption’ practices were enduring as local support services offices were closed.

When Capita took over the contract this year Pulse revealed how problems with the new online ordering portal had left practices without vital clinical supplies, an issue which Dr Nagpaul says has not been addressed and which ‘presents a significant risk to the care provided to patients’.

Pulse has also shown how practices have been left with piles of uncollected patients notes.

This has particularly affected student practices with a high patient turnover. Pulse has shown how one Huddersfield practice concerned by the potential for records to be lost in transit has boycotted Capita’s new record movement pilot – risking being found in breach of contract. 

Pulse heard the same practice was left missing seniority payments along with payment problems across East Anglia as a reuslt of NHS England’s failed handover. Dr Nagpaul highlights this has been an issue across the country, as well as concerns about management of the performers list.

Readers' comments (17)

  • Better late than never! Only motive for outsourced private companies is to make profit! GPC need demanding abolition of private provider Capita !

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  • Better late than never! Only motive for outsourced private companies is to make profit! GPC need demanding abolition of private provider Capita !

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  • Why are wasting time with demands like this - there is little or no chance of the government doing this.

    We need concerted action to reduce the workload in general practice - most people I speak to don't want more money but help with workload

    Things like giving hospitals FP10s and making them prescribe acute prescriptions, a national action on home visits, reducing the acute workload in general practice where we are expected to see anyone who calls or turns up.

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  • micturating into a hurricane again, Chaand?

    Best of British, old fruit.

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  • Peter Swinyard

    Madness - the system is being piloted in Yorkshire (I believe) for your sticky labels - but already rolling out across the country.
    The average jibbering idiot could have designed a better system. And when I listened to a lecture at the Essex LMCs Practice Managers' Conference yesterday (thanks for the invite chaps) from a lady from PCSE who said that she couldn't find where in the system a patients notes were as she did not have access to the capita computer it became clear that there is serious madness in this. I asked how practices were to be funded for the significant extra receptionist/admin time. Answer came there none.
    Fight this, GPC. Unless there is a regulation demanding that we envelope and label every set of notes, we should just give the driver a box of notes and say "your problem mate".

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  • On behalf of NHS managers have to say that Pulse's lazy use of the phrase "NHS managers" annoying - panders to the rather childish Dr/manager divide.

    As an NHS manager in a clinically led CCG I completely agree with the GPC - PCSE is a disaster and NHS England should compensate practices accordingly, out of the £40 million savings it demanded from the system.

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  • Well done Chaand for taking this up.

    We are being told to hand write labels, re-pack records- back to dark ages.

    No bar coded labels, process not thought through, no records received for 5 weeks now.
    Dangerous and in breach of Caldicott.

    No audit trail. Website not running properly.
    No response to emails or phone calls.
    No way to get urgent notes- system doesn't work.Some practices being told to post urgent records practice to practice. Need I go on..

    BTW, how can you "pilot" something after the "go-live" date?

    NHS England needs to commission this service properly. Capita needs financial penalties- it must be in breach of contract, these moneys to be handed to practices for now, and ongoing situation needs sorting asap.

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  • Why have we got here?
    The GPC failed to challenge this at the procurement stage, and have actively endorsed it. I wrote to our LMC in Feb and the GPC in march (see below) asking that they fight it BEFORE it did harm, and instead they said 'it'll be alright chaps, do the work for free' or did not respond.

    Why are we leaning casually on the recently closed stable door waving at a horse's arse again?

    Tue 08/03/2016 12:35
    FAO: All GPC Members, re Capita PCSE Contract

    To all GPC Members,
    Practices in our local area (North East Essex) have been hugely disappointed at the impositions involved in Capita’s PCSE contract, which predicate their ability to deliver the service on the unfunded transfer of huge volumes of workload onto General Practice at a time where workload saturation has been passed, and when workload remains a key issue in the retention of the inadequate number of GPs we have left.

    Given that the consistent message through the LMCs has been that practices must focus on safety, and refuse unfunded work dump, I struggle to understand how the GPC can endorse this approach. Clearly there are additional steps which we are not currently taking, and it feels that the information governance risk is being placed squarely on practices who will be threatened with contract breach notices for such failures. The 40% reduction in cost to NHSE will be in addition to Capita’s profit margin on the contract (usually 12.5-15% for corporates in our sector) and as such we’re undergirding their contract approach with our unfunded and unnegotiated labour and the additional resources and process change this results in. The lack of clearly articulated plans at a date so close to implementation suggests further that this project will be an unmitigated disaster; further leaching valuable time and energy from practices.

    As a patient I object to my personal medical history being carried by a jobbing courier and doubt that this will be safe and secure. And the fall back of a distant call centre in Leeds hardly fill me with faith and optimism, given the shambles that we saw with the transfer of practice payment management to Shared Business Services.

    I ask that you urgently reconsider your support for this approach, and whether this would be a sensible beach-head on which to finally take a stand on behalf of practices overwhelmed with work, and underfunded to collapse. Such a call to arms might act as a rallying point for the profession, and both encourage the unity so essential to future negotiation, and demonstrate the collective might of a profession too long scorned. If ever there was an issue with the potential for practices to unite behind in saying no, without adversely impacting on patients, I would think this is it.


    Paul Conroy
    Practice Manager

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  • No patient files again today, took plenty of files from us, but to where?

    Wholly unsatisfactory introduction and the extra overtime I'm going to have to pay when the files turn up and the ongoing adminstration of this is all unfunded. Can't believe that the costs to practices will be less that £40m and all for a much poorer service.


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  • This is Chaand's usual tactic of throwing a tidbit to the masses to make it look like he is doing something. The GPC will not follow this up, will not pursue it to some better conclusion. They never have in the past, all they ever do issue a letter for public consumption to make it look good on themselves and then they shut up. Don't want to upset the nice people who give out CBEs now do we?

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