Panel sides with GPs over private company in APMS contract dispute

An ICB has reversed its decision to transfer an APMS contract from a GP-led group to a private company.

NHS Sussex ICB announced its decision yesterday (24 July) following an independent review which found it had breached transparency rules during the contract bidding process.

The ICB had stated its intention to transfer the APMS contract for a practice in Whitehawk, Brighton, to One Medical Group, a private company providing primary care services.

The GP-led Wellsbourne Healthcare community interest company, which currently runs the service, appealed the decision to NHS England’s independent patient choice and procurement panel in May.

Following the publication of the panel’s findings, Sussex ICB said it had ‘taken a decision to stop the current process’.

NHS Sussex chief integration and primary care officer Amy Galea said: ‘We remain committed to delivering a high-quality, value-for-money GP services in Whitehawk that meets the needs of the local community.

‘We have received the report from the panel and need to take this into account and also recognise all of the feedback that we have received from service users, residents and partners over recent weeks.’

NHS England’s Independent Patient Choice and Procurement Panel said the ICB had breached Provider Selection Regime (PSR) regulations in four respects, most notably:

‘In not providing information to bidders about the locally commissioned services (LCSs) they might potentially supply’

‘In requesting bidders’ estimates of their likely income from LCSs and other sources without supplying information about these LCSs’.

During the evaluation process, bidders were asked to estimate additional income that they expected to derive from operating the practice, beyond APMS contract revenues.

These included Quality and Outcomes Framework (QOF) funding and income from locally commissioned services (or enhanced services).

Sussex ICB did not provide any overview of enhanced services or provide bidders with any information about income that bidders could potentially earn from these services, according to the panel.

The panel found these breaches to be ‘sufficiently serious to have had a material effect on its selection of a provider’.

It recommended the ICB restart the provider selection process after addressing the issues identified in its report.

Responding to the decision, Wellsbourne Health said: ‘We welcome NHS Sussex’s decision to bring the current procurement process for the Whitehawk Health GP contract to a close.

‘At Wellsbourne Healthcare CIC, our priority has always been the delivery of high-quality care to our patients.

‘We’ve served the East Brighton community for over seven years, and our roots here run deep.

‘We hope this decision marks a step towards a more stable future, one that recognises the value of relationships, continuity, and listens to the voice of this community.

‘We’ll continue to work constructively with NHS Sussex and keep you updated as we learn more.

‘We are pleased that NHS Sussex has recognised the need to pause and reflect before deciding next steps.

One Medicare, the healthcare division of Leeds-based One Medical Group, runs 16 healthcare sites and services in England and Scotland including 10 GP surgeries.

Earlier this month, the same panel backed Shropshire, Telford and Wrekin ICB’s plans to replace a GP cooperative with a private provider to run out-of-hours services in the area.

And last year, a Lancashire GP kept her practice’s APMS contract following a two-year, patient led campaign.

Private provider SSP Health had initially been awarded the contract, but this caused patient protests and the ICB was forced to re-run the procurement process.

The panel’s findings in full

The Panel finds that Sussex ICB’s provider selection process for the Whitehawk APMS contract has breached the PSR regulations in four respects.

First, the Panel finds that Sussex ICB, by conducting the evaluation and scoring process differently to the way in which it was described to Wellsbourne, breached the PSR regulations, and in particular its obligations under Regulation 4 to act transparently and fairly.
Second, the Panel finds that Sussex ICB, in evaluating Wellsbourne’s response to Question ITT02 (Communications) erred by concluding that Wellsbourne did not address certain issues when this was not the case, and as a result breached Regulation 4, which requires it to act transparently and fairly.
Third, the Panel finds that Sussex ICB: (i) in not providing information to bidders about the locally commissioned services (LCSs) they might potentially supply, (ii) in lacking clarity about its expectations of the LCSs that the successful bidder would deliver, (iii) in requesting bidders’ estimates of their likely income from LCSs and other sources without supplying information about these LCSs, and (iv) in evaluating proposals that contained a significant disconnect between the additional revenue estimates and the workforce and costs necessary to deliver this revenue, breached the PSR regulations, and in particular its obligations under Regulation 4 to act transparently and fairly.
Finally, the Panel finds that Sussex ICB, in its evaluation and scoring of Wellsbourne’s financial proposal, breached the PSR regulations, and in particular Regulation 24(g), which requires the ICB to keep a record of the reasons for its decisions.

The Panel also finds that Sussex ICB’s provider selection process for the Whitehawk APMS contract did not breach the PSR regulations in four other respects.

First, the Panel finds that Sussex ICB, in its pre-procurement public engagement, did not breach the PSR regulations, and in particular its obligations under Regulation 4, which requires it to act with a view to securing the needs of the people who use the services, and to act transparently, fairly and proportionately.
Second, the Panel finds that Sussex ICB, in the formulation of its ITT questions, did not breach the PSR regulations, and in particular its obligations under Regulation 4, which requires it to act fairly.
Third, the Panel finds that Sussex ICB, in deciding the weightings for the key criteria, did not breach the PSR regulations, and in particular its obligations under Regulations 5(e) and 11(2), which state that “Step 1 [of the competitive process] is that the relevant authority determines the contract or framework award criteria, taking into account the key criteria and applying the basic selection criteria”.
Finally, the Panel finds that Sussex ICB, in the selection of an evaluator related to Healthwatch, and in setting out the composition of its representations review panel, did not breach the PSR regulations, and in particular its obligations under Regulation 4, which requires it to act fairly.

Source: NHS England Independent Choice and Procurement Panel