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Practices suffering ‘significant and unpredictable’ disruption due to privatisation of support services

Exclusive Practices are receiving ‘misleading financial statements’ and seeing IT projects potentially fail as a result of the transition to the privatisation of primary care support services, the country’s largest CCG has said.

NHS England this week confirmed the terms of the £330m seven-year contract, which will see Capita will take over the running of primary care support services (PCSS), and centralise support services including management of GP practice payments, medical records and national cervical and breast cancer screenings from 1 September.

But NHS Birmingham CrossCity CCG has reported that the transition to this has seen disruptions to services ‘caused by reductions in staffing and the relative inexperience of the remaining staff’.

GPs have raised concerns about the support services in the past, especially regarding the issue of payments, but the intervention by the CCG represents the most high profile criticism by NHS managers.

LMC leaders have warned that problems are likely to get worse when the contract becomes fully privatised, with a plan to centralise services to three ‘centres of excellence’ each dealing with a single service area: screening services; payment services; and medical records, registrations and performers list services. .

NHS England revealed its plan to outsource the PCSS contract as part of a bid to cut costs by £40m last year.

Following on from this, it dropped responsibility for ‘non-core’ PCS services in April, including maintaining the patient population database and practice closure administration.

In June Capita was selected as the preferred provider for the new contract in a bid thought to be worth as much as £400m over a period of seven years.

But NHS Birmingham CrossCity CCG has said that practices are already suffering as NHS England has cut staff in preparation of the handover.

Minutes from the CCG’s primary care committee – which manages primary care under new delegated co-commissioning arrangements – state: ‘These on-going changes are continuing to have a significant but unpredictable impact on both operational work and general system resilience, seemingly caused by reductions in staffing and the relative inexperience of the remaining staff.

‘Recent examples include a practice IT system merger nearly being cancelled due to PCSS staff being unfamiliar with the Exeter system and multiple queries on misleading payment statements issued to practices…

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‘[We] are continuing to work with NHS England and PCSS staff to try to understand and minimise the risks due to this transition, however the situation is expected to continue to evolve for some time’

Local leaders across England have warned that practices are already struggling to get assistance or information on available services, but that ‘worse was to come’ as a result of the centralisation of services.

Dr Robert Morley, chair of the GPC’s contracts and regulations subcommittee and chief executive of Birmingham LMC, warned problems could spill into patient services.

He said: ‘LMCs are now experiencing significant delays in receiving their levy payments from practices’ with confusion between NHS England and PCSS over who is responsible.

‘The Capita contract will start shortly and sadly even greater problems can be predicted, with the privatisation covering not just finance, but other vital primary care support services such as patient records, registration services and cervical and breast screening.’

Berkshire, Buckinghamshire and Oxfordshire LMCs chief executive Dr Paul Roblin told Pulse there were ‘a lot of worries’ about what would happen in September, and said it was ‘phenomenally difficult’ to get information out of the closing PCSS provider.

Dr Roblin said: ‘We’ve already seen a lot of signs of fading pre-existing organisation, their staff were haemorrhaging and for quite a while their functioning has been compromised by the people who were leaving.’

An NHS England spokesperson said: ‘Capita’s proposed plans respond to NHS England’s objectives to realise significant savings and service improvements. These proposals have been shared with PCS service staff and the unions, and will form the basis of a full consultation about the impact of changes once the service has been transferred from NHS England to Capita.’

A Capita spokesperson told Pulse: ‘The contract that NHS England has awarded to Capita is to provide service improvements and efficiencies in delivering these – the safe and efficient delivery of these services is a priority. Capita’s proposed plans entail a phased modernisation programme over a two-year period and this new business model proposes the introduction of a dedicated team of mobile employees to provide a local presence for service users.’