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Procurement breach throws 111 pilots into disarray

Exclusive A series of pilots for the Government’s new flagship urgent care number 111 have been thrown into chaos after contracts were torn up at the last minute because PCT managers were found to have breached procurement regulations.

Contracts for pilots covering NHS Westminster, NHS Kensington and Chelsea, NHS Hammersmith and Fulham and NHS Hillingdon were pulled after NHS North West London admitted its decision to award contracts without any tender process could be open to legal challenge.

The move has raised fears that pilots elsewhere in the country, some of which have also been awarded rather than put out to tender, could also be open to challenge – a prospect which could throw the national deployment of 111 into disarray.

The Hillingdon pilot, awarded to the GP-led private out-of-hours provider Harmoni and due to be the first 111 service to allow direct booking of routine GP appointments, was shelved just two days before it was due to go live. Pulse understands the move has triggered anger from local GPs who had invested time and resources in planning how to integrate with the 111 pilot.

An NHS North West London spokesperson said: ‘The decision has been taken to delay the rollout of the pilot NHS 111 service in inner North West London PCTs and NHS Hillingdon as it did not meet our standing financial instructions or the rules laid out in the Public Contracts Regulation 2006. This could lead to the risk of a legal challenge if allowed to continue.’

NHS North West London refused to confirm how much the cancelled contracts were worth, or if they had awarded any compensation, but said it would now launch an ‘accelerated procurement process’ in line with procurement regulations, to be completed by Spring 2012.

The wider impact of the decision remains unclear, amid confusion over whether NHS trusts are required to put pilots out to tender. Contracts for the full rollout of NHS 111, some of which are expected to be worth as much as £100m, will need to undergo a full competitive tender process, but the Department of Health told Pulse there was no central guidance on whether pilots should be put out to tender, and it was considered a matter for ‘local commissioners, subject to their legal advice’.

The DH could not say how many 111 pilot contracts had been directly awarded nationally, but a contract for the 111 pilot in North Derbyshire, which went live earlier this month, was awarded to out-of-hours provider Derbyshire Health United without any tender process. NHS Derbyshire Country said a full tender process would be run at the end of the two-year pilot.

Dr Richard Vautrey, GPC deputy chair, said: ‘GPs are right to be angry about this, but it also reflects the complexities of the 111 procurement agenda and the pressures PCT clusters and CCGs are under because of the very tight timescale set by DH.’

Dr Agnelo Fernandes, the RCGP’s urgent care lead and chair of Croydon Healthcare Consortium in Croydon – where Harmoni has just been awarded a contract for NHS 111 pilot after a limited tender process – said: ‘In reality you’ve got to follow what the lawyers tell you, and there should be some sort of procurement or limited procurement for pilots.’

‘They are pilots so they are not covered by the same rules as full procurement but CCGs need to cover themselves by doing some kind of limited procurement, even if it is a pilot for 111.’

Mike Barradell-Smith, marketing director at Harmoni, said: ‘We are expecting to be a major player providing 111 services across the country. We are the preferred provider for Croydon, which is due to go live in the spring, and we are in detailed discussions regarding 111 services with PCTs in other parts of the country. As such, we are continuing our recruitment of 111 staff.’

‘We would not wish to comment on any other procurement processes involving specific pilots as these are the responsibility of the PCTs.’



RCGP chair Dr Clare Gerada will be answering your questions in a live webchat this afternoon. Click here to view the webchat and submit your questions from 2pm.