CCGs are failing to provide adequate oversight that care delivered by private providers is high-quality and value for money, a report has said.
The Centre for Health and the Public Interest’s report ‘The contracting NHS – can the NHS handle the outsourcing of clinical services?’ surveyed of 181 of the 211 CCGs in England found more than one in ten (12%) CCGs did not conduct site inspections of private providers holding NHS contracts and 60% had no record of site inspections.
The report found oversight was hampered by CCGs subcontracting the monitoring of contracts to commissioning support units, which are currently part of NHS England but due to be privatised by April 2016.
This meant that many commissioners were unable to answer questions about how many contracts they held, or the oversight arrangements, despite CCGs maintaining statutory responsibility for the quality of care provided.
It also supports previous findings that CCGs are unwilling to use penalties for private providers, with only 16 imposing any form of financial sanction.
It notes that Serco’s management of out-of-hours GP services in Cornwall was an example of this, a contract now run by a local GP federation after the private group pulled out.
The report found just seven out of 15,000 CCG contracts with private providers had been terminated for poor performance and only 134 contract query notices had been issued.
The report states: ‘[The report finds] an NHS poorly equipped to ensure that healthcare services outsourced to for-profit providers will provide safe, high-quality care and good value for money.’
It recommends that NHS England should ‘commission an independent audit of CCG’s capacity to monitor and manage contracts with non-NHS providers’ before arranging further major contracts, and also calls for CCGs to publish ‘regular performance data’ on contracts with the private sector.
If they win the next election the Labour party has pledged to repeal the Health and Social Care Act which increased the role for private providers and competition for NHS contracts, a pledge now included in the party manifesto.
However NHS England’s chief executive Simon Stevens has said moves to end the role of competition ‘would not be lawful’.