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Private firms in talks on spending NHS cash

By Gareth Iacobucci

US giant United Health is among a clutch of companies in talks with NHS bodies that are set to give the private sector an important say in how the health service spends its cash.

The US-firm, one of 14 approved companies on the framework for procuring external support for commissioners (FESC), is leading the charge to provide commissioning support along with rival firms BUPA and Humana.

Pulse has learned all three companies are in discussions with at least three of the Government's pilot areas - Ashton, Leigh & Wigan PCT, North East Lincolnshire PCT and East of England SHA - having been ‘pre-approved' to provide individual commissioning functions.

The Department of Health wants trusts to agree deals as soon as possible, to kick start its World Class Commissioning programme. Mark Britnell, the department's director general of commissioning and system management, last week told the cross-party parliamentary group on access and health improvement the NHS needed to be ‘less precious' about receiving support from the private sector.

But the moves have prompted concerns from the National Association of Primary Care over potential conflicts of interest, even though ministers have vowed FESC commissioners will be kept away from areas where they provide services.

East of England SHA told Pulse it could sign FESC contracts by September, and is talking to all three companies, plus insurance company Axa.

Ashton, Leigh and Wigan and North East Lincolnshire PCTs are also in talks with the trio, as well as McKinsey, Tribal and, in the case of the latter, Navigant Consulting.

PCTs can sign more than one FESC contract, although most are expected to select a single company.

But Dr James Kingsland, NAPC chair and a GP in Merseyside, said United Health's role in provision of primary care and consultancy on active case management could ‘very much' bring conflicts of interest, and that he had concerns over FESC more generally. ‘I've got worries about the FESC programme and the need for it. If a FESC commissioner wants to provide, you've got to ask some very serious and far-reaching questions about why.'

A United Health spokesperson said: ‘As the FESC contract makes clear, United Health could never act as both commissioner and provider in the same area. We take this commitment very seriously. It is possible we will be offering case management, but this would be delivered as a core element of any FESC contract, not outside of it.'

The DH said it was up to PCTs to ensure ‘conflicts of interest will be prevented.'

Not here you don't: a patient gets his message across Not here you don't : a patient gets his message across FESC pilot areas FESC pilot areas

Ashton, Leigh and Wigan PCT
Deal with one of the following could commence in May 2008:
United Health

East of England SHA
Contracts could be signed by September
Currently discussing with:
United Health

North East Lincolnshire PCT
Currently discussing with:
United Health

Hillingdon PCT
Signed deal with BUPA in January 2008

Cambridgeshire PCT
Pulled out of FESC but will continue to support the East of England SHAs role.

West Midlands Commissioning Business Support Agency (CBSA)
Currently ‘pausing and taking stock of options following completion of a Strategic Outline case.

Hampshire PCT
Will present final Business Case to Boards in late summer

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