By Gareth Iacobucci, Emma Slater
Exclusive: At least half the board members of some GP consortia have links with a single private healthcare company, a joint investigation by Pulse and The Bureau of Investigative Journalism reveals.
Assura Medical, majority controlled by Sir Richard Branson's Virgin Group, has links with 50% or more of the board members at three of the 52 first-wave GP pathfinders.
The Department of Health responded to the investigation by saying it planned new guidance on the make-up of consortia and how to deal with potential conflicts of interest following Professor Steve Field's ‘listening exercise' report.
Findings by TBIJ, a not-for-profit organisation based at City University, London, show one in seven board members of first-wave consortia has a link to a private company, defined as an association registered by PCTs, a financial link recorded in Companies House records, employment by a company or employment by a GP practice in partnership with a company. That compares with an earlier Pulse investigation finding one in 10 consortium board members were directors of private providers.
More than 60% of those with private links were associated with Assura. Most were GP members of Assura, meaning their practice had formed a joint company with it. These companies provide community-based services in areas such as dermatology, sexual health and out-of-hours care, with profits split 50:50 between Assura and member practices.
At the Sutton Consortium in Surrey, 15 out of 25 board members are linked to Assura Medical. In the South Reading Consortium, three out of six board members are GP members of Assura, and two are employees of an Assura member practice. At the Calleva Consortium in Basingstoke, Hampshire, five out of 10 voting members on the consortium board have links with Assura, as does the non-voting board secretary.
An Assura Medical spokesperson said the company was awaiting DH guidance on approaching potential conflicts of interest and would ‘ensure our policies are updated to reflect and reinforce this guidance'. The spokesperson added: ‘Most services will be purchased under any qualified provider, meaning consortia will not be responsible for deciding providers, but in specifying the outcomes required – thus no conflict of interest exists.'
The DH said it would consider creating a new statutory body to oversee commissioning decisions where 50% or more of a consortium board would be prevented from taking part because of other interests: ‘We [will] ensure governance arrangements are robust. The NHS Future Forum is looking at this and will present findings shortly.'
Some 19 of the 52 first-wave pathfinder consortia had board members with interests in commercial providers – 65 board members in total, including 44 with links to Assura.
The Sutton Consortium said it would be ‘developing our governance arrangements over the coming months to ensure we continue to be transparent and accountable'. NHS South West London said none of the board members were members of Assura Wandle LLP clinical management board.
Dr Elizabeth Johnston, chair of South Reading Consortium, said protocols had been ‘transparent' and would be strengthened by publishing board minutes. No one was a board member of both the consortium and Assura, Reading.
BMA guidance released last week suggested where the majority of board members had a potential conflict of interest, an ‘appropriate independent body' should oversee decisions, such as ‘a neighbouring consortium or an audit committee'.
GPC chair Dr Laurence Buckman said: ‘Conflict is in the eye of the beholder. People mustn't think this somehow impugns their integrity – it's not. It's saying, if it looks dodgy, it's dodgy.'
NHS Alliance chair Dr Michael Dixon, a GP in Cullompton, Devon, argued there was ‘a strong case' for GPs to step down from either their provider company or consortium board if part of a majority with dual interests. ‘Links to private providers should never be a majority,' he said.Sir Richard Branson's Virgin Group controls 75% of Assura Medical, which is in partnership with many GPs Assura links
The Sutton Consortium, Surrey
25 board members in total: 14 are GPs who are members of Assura Wandle and one is an employee of an Assura Wandle practice
South Reading Consortium, West Berkshire
Six board members in total: three are GPs who are members of Assura Reading and two are employees of an Assura Reading practice
Calleva Consortium, Hampshire
11 board members in total: five are GPs who are members of Assura Hants Health and one, not a GP, is a non-voting board secretary employed by an Assura Hants Health practice
Join our online masterclass in maintaining your practice income and hitting the new QOF and DES targets from 2pm today. Click here for more detailsGPC guidance on conflicts of interest