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First CCGs under investigation for breach of competition regulations

Two CCGs have become the first to face a Monitor investigation over breach of competition rules after being accused of directing patients away from the local private hospital.

The competition regulator has opened an investigation into whether patients were disadvantaged by the way non-emergency hospital services were purchased by Blackpool CCG - which is led by Dr Amanda Doyle, the co-chair of NHS Clinical Commissioners leadership group - and Fylde and Wyre CCG in Lancashire.

This follows allegations made by Spire Healthcare Limited that the CCGs had asked GPs to direct patients away from Spire Fylde Coast Hospital and towards Blackpool Victoria Hospital.

However GP commissioners at the two CCGs said they ‘strongly refuted’ and ‘deeply resented’ the allegations.

A Monitor spokesperson confirmed to Pulse that this was the first time a CCG was under investigation for potential breach of competition regulations since the Health and Social Care Act was implemented on 1 April. The reforms included the controversial Section 75 clause, which compels commissioners to put all services out to tender unless they can prove there is only one viable provider.

The regulator said: ‘Monitor will examine arrangements made by these two CCGs to purchase planned care and to offer patients choice. Monitor will consider whether these arrangements were consistent with the NHS competition rules which came into force in April 2013.’

‘Monitor will now gather and review information from Spire Healthcare, Blackpool CCG, Fylde and Wyre CCG and other relevant organisations before deciding how to proceed.’

Catherine Davies, executive director of co-operation and competition at Monitor, said: ‘Following a complaint by Spire Healthcare Limited we are investigating the allegations that patients have been directed away from Spire Fylde Coast Hospital and towards Blackpool Victoria Hospital. Spire believes this is not what is best for patients.’

‘The investigation is at an early stage and Monitor has not yet reached a view as to whether there has been any breach of the rules. We are now seeking further information from the organisations involved. If we find that a breach has occurred we will investigate whether patient interests have been negatively affected by these decisions.’

However, Dr Amanda Doyle, chief clinical officer for Blackpool CCG, said she ‘deeply resented’ the accusations.

She said: ‘We are extremely disappointed that Spire chose to refer their concerns to Monitor as their first line of action, rather than to have a conversation with us as commissioners.’

‘Although we are happy to work with Monitor to assist their investigation, there is not a shred of evidence to substantiate Spire’s supposition that we have told GPs to direct patients to any particular provider, and I, personally, deeply resent the accusation that either Blackpool CCG or its constituent GPs have acted in any way other than in the best interests of our patients.’

Her line was supported by Dr Tony Naughton, clinical chief officer of Fylde and Wyre CCG, who said: ‘We are extremely disappointed that Spire has chosen to refer to Monitor rather than explore and understand any changes in referral patterns with us as commissioners locally.’

‘We absolutely refute the allegation that either the CCG or local GPs have sought to inappropriately influence where patients may choose to have their treatment.’

‘We look forward to fully supporting Monitor as they carry out their investigation.’

Related images

  • Amanda Doyle - online

Readers' comments (11)

  • This sets a worrying precedent. I think GPs should call the governments bluff on this one and act in the best interests of their patients. Monitor will ultimately fail under the weight of legal costs if no-one buys into this artificial market system.

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  • This was always going to happen - the government set up the rules this way.

    To all of the CCG members: does your place on the board still seem like such a good idea? And is it worth the fees (which in our area won't even cover the cost of a locum)?

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  • competition isnt going to drive down costs it will simply close some hospitals

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  • Private hospitals discriminate against mentally ill patients by refusing to treat those that might deteriorate- read the fine print on C&B. Hence I offer choice but with careful direction and never failed once to send to the nearer NHS facility.

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  • lots of hot air.somethings cooking.........

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  • Who monitors "Monitor"??? They themselves are effectively unregulated.
    We should all leave Medicine. I, for one, would willingly sacrifice my career and my house if it meant political justice for Jeremy Hunt or Paul Dacre editor of The Daily Mail but I concede that these people are out of control and way beyond any form of regulation.

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  • The way around this is for commisioners to provide local GPs with useful referral information.This would be stats on the hospital, what they do and do not treat, how they perform in various areas, integration and joined upness of care (ie if you refer to private hospitals, there is often no integration). Surely then GPs are entitled to make a decision in the best interests of the patient and direct them to the service that best meets their needs?

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  • For those that offer 'ways around this' you are simply confirming that choice is not offered as per the rules.

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  • I offer choice everytime. To see someone I know about or go to another on C+B list that I have no idea about.
    Have a guess on the results?

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  • this was waiting to happen
    its sad that the spire which is loosing its grounds in service provision is now bickering
    yes there will be winners and losers
    spire has enjoyed lot of money from the trusts now lets come to the playing field as there are many excellent private providers
    chin up spires and learn to compete

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