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GPs go forth

What has happened to primary care support services?

Pulse looks at why practices are suffering disruption

What are primary care support services?

They are responsible for making payments to practices, checking patient lists, transferring patient records following new patient registrations and supplying medical equipment.

What has happened to these support services?

In March 2014, NHS England announced it would save £40m of the £100m budget for primary care support services by cutting services, including some courier services and contacting patients to inform them when a practice closes.

In July 2014, it said it was outsourcing support services to a single provider, which would replace its local offices.

Who won the contract?

In June 2015, Capita was successful with a bid that proposed to run support services through three national hubs – one for screening services, one for payment services, and one for medical records, registrations and performers list services.

When did the problems for practices begin?

There were major problems with payment services even before NHS England announced there would be cuts, with practices routinely facing delayed payments.

However, after NHS England began winding down its operations, further problems arose with the transition. NHS Birmingham CrossCity CCG – the biggest in England – warned practices were receiving ‘misleading financial statements’ and seeing IT projects potentially fail as NHS England phased out local offices. In the Thames Valley area, 30 trainees were mistakenly taken off the performers list due to primary care support services failing to file the relevant documentation.

What happened when Capita took over responsibility?

Capita began taking over support services at the start of 2016. By April, Pulse revealed that practices were running low on FP10 forms and blood vials, and there were reports of staff spending 30 minutes on the phone to Capita support services due to problems with the online portal used to order stock.

Capita tells Pulse it has temporarily ‘paused’ collection of patient records, leaving practices to stockpile them while they wait. Pulse has also revealed that the transfer of patient records has been delayed and there is evidence some have been misdelivered.

Meanwhile, practices have also reported missing payments for enhanced services and seniority.

What has the reaction been?

In May, the GPC sent a letter to NHS England demanding practices be compensated for the ‘systematic failure’ of support services. NHS England tells Pulse it vows to hold Capita ‘to account’ for disruption.

Capita has now brought in measures to ensure there is at least one collection a week from practices, and put more workers on its helplines.

What is happening with patient records?

The problems with the transport of patient records come as Capita is piloting a new secure collection service that will allow practices to track records online.

The pilot of this new secure collection service in West Yorkshire has so far received no complaints about records going missing, although the process may have significant workload implications. It requires practices to bag hard copies of patient records individually and match them to a printed barcode when the patient transfers to a new practice. Practices then have to do the online tracking of the delivery themselves.

Janet Hallam, practice manager at The Student Health Centre in Huddersfield, says her university practice has boycotted the scheme. She says: ‘Previously we would just have handed the sealed box of records to the courier, but now we are expected to match each set of notes up with the label and put it into a special delivery envelope and then add the label to the envelope, sealing it.’

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Readers' comments (9)

  • Dear All,
    What has happened is that NHSE has given a contract to Capita for 40% less than it used to pay PCSS services. That 40% has been re-couped by Capita and NHSE by expecting GP staff to do the sorting , collating, bagging and labelling of individual medical records in our surgeries. In other words we are now doing their work for them and for no extra money.
    There needs to be an option whereby teh practice can simply give the Capita driver a single sack with all the deducted records and let Capita do the bagging and labelling on their premises.
    Paul C

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  • I am not surprised at all, particularly if Capita has "inherited" some officers from SBS. I have been monitoring few applications for National Performers List, which last summer have been submitted via NHSE Shared Business Services. Dormant files, mishandling DPA or personally sensible information, failure to recognise the certificates (including essentials like GMC). Let alone poor spelling of English, lack of IT knowledge or simply courtesy in communication. Criteria of employment for PC support services should be rigorously reviewed.

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  • I work for an alliance of 45 practices in Nottingham, and we are preparing to submit a formal complaint to the Information Commissioners Office (ICO).

    Medical records are being delivered to the wrong practices and being returned to the originating practice.

    As notes only get requested once a patient has moved practices, and this is updated on the spine, surely if Capita's working systems were fit for purpose this simply couldn't happen?
    In once instant the same set of notes was returned to the orginating practice twice!

    This is a massive IG breach, and it needs to be sorted now before we see medical notes being discovered in skips, or floating down the Trent.

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  • This a classic failure of new system developed by consultants hired by NHS.
    The lessons from past fails are never learnt!
    First requirement for a tender is specification.Since most of the existing systems are combination of both formal which is documented and informal system which are developed to counter the shortfall of the original system which is never documented.
    So when you design a new system based on computer it is obvious to any reasonable person that system will fail like night comes after day. After few years of messing around final either revert back to old system or modify the new system locally to make it work or by pass the system altogether.After all it is best healthcare system in the world!

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  • Cobblers

    Our practice is winding down (Retiring) and we had something like 200 sets of notes bagged and ready to go. Despite several telephone calls with the Capita lady assuring us they would be collected they took 3 weeks. The van man turns up and says his van is too small and buggered off not taking any! A week later same man, same van and he provides us with polyester sacks into which notes go and we fill the van. I ‘borrowed’ a couple of sacks and they are now filled, sans envelopes, and ready to go for this week. Cross fingers

    A system, which was by no means perfect, has been made a hell of a lot worse by idiots who ‘save money’, only to find they have to spend that money and more to rescue the mess that they have helped create.

    Let’s have names of these idiots and metaphorically have their heads (jobs) when it goes t!ts up.

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  • This is all a complete disaster here in London. Driver said today 'my truck is full, can't take your notes...but here some more'. Labeling is a diabolical time waster. General Practice utterly dumped on with no say. Horrible.

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  • You were # told and you didn't # listen. So now its a # mess. # idiots.

    # = expletive of your choice.

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  • Vinci Ho

    So while CQC is so on about information governance , training on that , Caldicott principles and Data Protection Act etc as far as a GP practice is concerned , NHSE and the government appointed an organisation breaking all rules. Where the hell is the Health Secretary for this dangerously flawed hypocrisy ?
    If a computer system generating a wrong 10 years cardiovascular disease risk can cause some fuss leading to the SOS calling a pause in contract negotiation , where is the unequivocal , equivalent response in this saga on Capita? Perhaps the SOS does not even know what is GP support service and positive response to this crisis will never earn 'juicy' headline in tabloid papers and other media.
    This is a legacy as well as fallacy of efficiency saving , the creator(s) of which should be held accountable .

    The PM can say so much about 7 days NHS , reducing antibiotics resistance etc but if the fundamental virtue of confidentiality in handling patient's records cannot even be maintained , this government derserves no credibility from the public to handle the health service. Yes , there may be an argument when all records are electronically held and transferred (GP to GP), there may not be any problem at all . But even so , can you give your trust? We all know where we stand as far as is concerned!

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  • Bring back Family Practitioner Committees. This sort if thing didnt happen in those days.

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