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GPs buried under trusts' workload dump

Private consultancy firms paid millions in run-up to commissioning

Exclusive: PCTs have paid millions of pounds to private consultancy firms to prepare CCGs for authorisation and begin commissioning services, a Pulse investigation reveals. 

Managers have spent an estimated £26m so far this year with companies including PricewaterhouseCoopers (PwC) and Capita for CCG projects such as ‘mock authorisation panels’ and training programmes, and to compensate for the lack of experienced managers left at PCT level.

The figures, obtained from 48 PCTs in England under the Freedom of Information Act, show trusts have spent an average of £173,000 on private consultancy support so far this financial year, equating to an estimated spend of £26m across the 152 PCTs in England.

A Pulse investigation in January showed that 40% of CCGs were consulting private firms, but this is the first indication of how much that advice is costing and what it is being used for.

If the spending is extrapolated through to next April, payments to private consultancies appear largely unchanged this year compared with last. Total spending reported by those who responded stood at £8.3m for the first half of 2012/13 and £17.7m for 2011/12, following a big drop from the £24.2m spent in 2010/11, NHS Oxfordshire, NHS Derby City, NHS Buckinghamshire, NHS Peterborough and NHS Portsmouth were among the trusts to report spending more than £2m on external support since April 2010. 

While not all the PCTs were able to specify how much had been spent on CCG preparation, NHS North of Tyne said it had spent £467,000 onmanagement support for just one CCG, Newcastle West, since 2010.

Newcastle West CCG chair Dr Guy Pilkington said support from private firms had been necessary because of a lack of staff at the PCT.

He told Pulse: ‘All were taken on to support specific clinical projects and this was at NHS rates. Will we be requiring consultants in the future? Probably, but far less once we go live.’

Dr Stewart Findlay, interim accountable officer for the Durham Dales, Easington and Sedgefield CCG, said: ‘We used them because everyone in the PCT already had a day job, so we needed the capacity quickly.’

NHS Nottingham City spent £50,700 on advice on collaborating with other CCGs and £15,000 on a ‘mock authorisation panel’.

Dawn Smith, chief officer designate, said the work was ‘helpful in ensuring that this part of the process went smoothly both for us as a CCG and the authorisation panel’.

The extent of spending was far from universal: NHS Devon, Plymouth and Torbay PCT cluster and NHS Calderdale recorded no such spending.GPC deputy chair Dr Richard Vautrey said: ‘We have had a hugely expensive reorganisation seemingly creating a need to spend millions of pounds that could have been spent on care.’

Dr Paul Hobday, a GP in West Kent, said: ‘This was already happening, but the reforms have given licence for this to take off in a bigger way. The easiest route is to farm it out and the taxpayer pays the bill.’ 

Private consultancy spending

  • Newcastle West CCG has spent £467,000 on management support since April 2010
  • Nottingham City CCG paid £115,000 to Capita and £50,700 to PricewaterhouseCoopers 
  • North Lincolnshire PCT spent £122,000 on developing ‘sustainable services’ for CCGs
  • Durham Dales, Easington and Sedgefield CCG spent £108,000 on organisational development and preparation for authorisation

Click here for our interactive map showing spend by PCT

Source: FOI responses from 48 PCTs

Readers' comments (11)

  • A pattern is emerging. PCT directors have looked after themselves by working out generous MARS schemes, taking a fat redundancy, then selling themselves back in (often with "preferred supplier" status) to the CCG because they aren't available at the PCT. Meanwhile some absolutely terrible PCT senior management are moving to the Commissioning Board, continuing to obstruct and insult and do what they have always done. Will the CCGs be allowed to do anything about it? Nope - the rules keep changing but at the moment, NHS CB can terminate the contract of any GP practice that complains on the grounds that "they aren't cooperating with commissioning".
    Pattern? It was the Executive Directors (not the hospital managers) who failed at Mid Staffs - but everyone still blames the managers. It was the Chief Executive (again not managers) at Ashford & Tunbridge Wells who caused the deaths of 80 people - and then was paid large sums to do consultancy for the SHA. Jobs for the boys, or what?
    Will we ever let Doctors decide on behalf of their patients, and Doctors appoint the ADMINISTRATORS (ie people who make things run smoothly, rather than Managers who feel they have to boss people around) who will do the job required? Not under this government, it seems

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