Exclusive Four in ten clinical commissioning groups across England have begun to enlist commissioning support from the private sector and have already signed a series of deals with external firms, a Pulse investigation has found.
An analysis of data from 86 CCGs obtained under the Freedom of Information Act shows 41% have taken on external commissioning support outside the NHS, spending an average of £76,472 each and £2,753,000 in total.
While the early spending is largely focussed on preparing CCGs for authorisation, the figures will add weight to fears that NHS commissioning will be privatised in future.
It comes after commissioning leaders in London representing several thousand GPs signed a £7m deal last October with private consultants for organisational support by NHS London. While many London CCGs had not responded to the Freedom of Information request as Pulse went to press, our analysis found at least 30 CCGs outside London have also now signed deals, collectively worth more than £2m.
Recent Department of Health guidance recommends that commissioning support should be run by arms lengths bodies hosted by the NHS Commissioning Board from 2013, and fully opened up to the market by 2016, leading the BMA to warn support services for CCGs would be provided solely by large commercial organisations.
Among the areas outside London to so far enlist private support, Runcorn CCG paid £204,000 in the past two years to Catch On Holdings Ltd for ‘commissioning support, business management and organizational development functions’, while NHS Hertfordshire paid £115,579 to three firms in the same period to provide consultancy, strategic advice and a service to support performance management to its CCGs.
Four CCGs in NHS Surrey paid £409,473 to Integrated Health Partners for services including organisational support and QIPP delivery in 2010/11. The trust said a further two firms – Health Systems Policy and Practice Ltd and Progate Ltd – had been enlisted to provide support during 2011/12, but could not provide a figure until the end of the year.
Dr Chaand Nagpaul, GPC negotiator, said: ‘These figures highlight why we are concerned that CCGs will increasingly be reliant on external support by default because it’s the only option available to them. We are concerned this will become widespread and the norm.’
‘CCGs should not be rushed into accepting models of external support. It isn’t a cost-effective and accountable way of structuring commissioning.’
But Dr Sam Everington, chair of Tower Hamlets CCG, which has spent £181,768 on external support, said commissioning support should not be judged purely on where it comes from. ‘It depends what it’s being spent on, and whether it represents value for money,’ he said.
Dr Mark Spencer, a GP in Acton and executive member of Ealing Commissioning Consortium, said: ‘The DH guidelines are very clear that all commissioning support has to be externalised. The current organisational support has been a benefit. It means the existing staff are more likely to be in a position to fight off external NHS competition [in the future].’
– 41% – proportion of CCGs to have spent some money on external commissioning support outside the NHS
– £76,472 – average amount spent by CCGs on external support
Source: FOI data from 86 CCGs