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GP support services could be ‘offshored’ to India

Exclusive Administrative support services for GPs could be outsourced to India under proposals to be considered by NHS England to slash costs, Pulse has learnt.

The proposal, which could involve unidentified support functions being ‘off-shored’ to NHS Shared Business Service’s operations in India, is one of two proposals to provide services that also include processing medical records and performer and contractor list administration.

NHS England will vote on this proposal at its board meeting next week, alongside an alternative proposal to keep the services in-house but reduce the number of offices from 38 overall to 13, and a third option billed as ‘full market testing with an open public procurement’.

But GP leaders have said that removing the local aspect of the support services could lead to the loss of local expertise, which could cause further problems for practices.

The vote, which will take place in a closed session at the board meeting, follows a review of support services intended to save £40m from its £100m primary care support services budget, including cutting a series of services no longer to be centrally funded.

The proposal by Shared Services Connected Limited (SSCL) – a joint venture between the Cabinet Office and Steria – would see it subcontracting the service to NHS SBS, which itself is a joint venture between the Department of Health and Steria, and is currently responsible for administering GP payments.

Some staff would also subcontracted to another private company working with Steria, called Crown, and some functions could also be outsourced to India.

In a briefing document, NHS England said: ‘SSCL has indicated that it would build on the NHS SBS existing sites in the South, Central and London regions and establish new bases in the North. Their business model would be similar to that currently operated in the South-West of England. This proposal would therefore result in the closure of a number of current NHS England PCS sites.’

‘A small proportion of posts will be further sub-contracted to an NHS Shared Business Services delivery partner (Crown). Other functions may be considered for being off-shored to NHS SBS’s existing operations in India; this element is still to be agreed.’

This follows previous attempts by PCTs to outsource services to India via NHS Shared Business Services, which led to a series of complaints from GPs in 2011.

The other option would see NHS England keeping the service in-house but reducing the number of locations from which it undertakes the work.

While both options would see a reduction in services offered and the number of locations from which they are undertaken, members of the GPC have criticised plans for outsourcing the function, questioning whether it would lead to a further loss of ‘organisational memory’ from the old PCTs.

Dr Robert Morley, GPC member and executive secretary of Birmingham LMC, said NHS England’s vote was ‘a big concern locally’.

He said: ‘We have warned practices that this might happen, that they might lose their local health services [support] function and that it may get handed to a single, national provider. That they will lose their local contacts and local corporate memory.’

Dr Brian Fisher, chair of the Socialist Health Association, said: ‘We see almost no benefit from outsourcing to the private sector. There are so many examples now of bits of the NHS, both administrative and clinical, that have gone over to the private sector and the quality of service is by no means any better.’

‘In principal, I can’t see what benefits there are to the NHS for money to be siphoned out to shareholders – and I don’t see any reason why they should be able to do it cheaper [except] hiring people on poorer conditions and with fewer skills.’

A spokesperson for SSCL said: ‘SSCL has submitted a proposal to NHS England to provide primary care support services nationally. Under the proposal NHS SBS would act as the subcontractor in the delivery of the service. As the proposal is still under consideration we are unable to comment further at this stage.’

Note: This article was amended on 12 May to reflect that NHS England will look at three options for the future of primary care support services.