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NHS to withhold report on primary care support problems until 2017



Exclusive NHS England will wait more than a year before it publishes its report of serious and significant events recorded for primary care support services since Capita took over.

Pulse has learned that NHS England intends to publish an annual round-up of the problems raised by practices, but the first publication – due July 2016 – will only cover issues reported by 31 March this year.

This will not include the details around the piles of uncollected patient notes and dwindling stocks of essential clinical supplies, which have happened since the new national system went live at the start of April.

LMC leaders are also reporting that GPs have ‘given up’ on flagging concerns because they are fatigued with the number of problems they have to document.

GP leaders have labelled NHS England’s decision a ‘bloody disgrace’, adding that Capita is operating under different standards to practices that are required to regularly audit and learn from significant events.

Capita has previously said about the problems: ‘NHS England asked Capita to transform what was a locally agreed, fragmented primary care support service, to a national standardised system. Our focus has always been to ensure we achieve an efficient, effective and modern service, that reduces the administrative burden on primary care staff.

’It is inevitable that with such significant structure change there will be initial challenges. However, we have been, and are continuing to, work closely with NHS England to ensure the service is delivered at an optimal level.’

Pulse submitted a Freedom of Information request to NHS England – as it is responsible for commissioning the services – asking for details around the number and nature of serious and significant events to be made public.

But NHS England told Pulse: ‘We plan to publish the data requested in this FOI request on an annual basis via the Capita PCSE (Primary Care Support England) web site.

‘The details of the preceding financial year will be published by 31 July the following year. So by 31 July 2016 we will publish details of incidents reported in the year to 31 March 2016.’

The report in July will include details around the ‘significant unpredictable disruption’ before Capita’s tenure and in the early stages of the contract.

But this was largely due to the previous patchwork of support service contracts ending, and in many cases – such as missing enhanced service payments in East Anglia – Capita had not changed systems from those it inherited.

Dr Robert Morley, chair of the GPC contracts and regulation subcommittee, said GPs have a duty of candour to report incidents ‘as soon as reasonably practical’.

But he added: ‘NHS England is burying its head in the sand over the problems caused by its awarding of this contract; it must be held fully to account over the consequences.’

He said: ‘This is an absolute bloody disgrace. Clearly it would appear that NHS England, as a commissioner, and Capita as its agent providing vital primary care support services, can operate under entirely different standards than those providing NHS care at the coalface.’

Dr Morley said GP practices are ‘under siege’ by the regulatory requirements, including significant event reporting, duty of candour requirements, and scrutiny from NHS England, CCGs, the CQC and more.

A recent update from Cambridgeshire LMC warned that GPs were so fatigued by continuing issues many had stopped flagging concerns and could be ‘culpable’ if something unreported caused patient harm.

NHS England declined to comment further, Capita said it was not their role to comment on complaints reporting.

The problems with support services

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NHS England opted to save £40 million a year from its support services budget and tendered for a single national provider for Primary Care Support England (PCSE).

The winner, Capita, has centralised support services to three national hubs and implemented a single online ‘portal’ for practices to order supplies and ‘track’ the movement of patient records.

Pulse has documented issues, from FP10 shortages, to patient notes turning up in a carpark, that have spiked since April’s overhaul and GP leaders have been urging practices to report every issue to NHS England.

GPC chair Dr Chaand Nagpaul wrote to NHS England demanding practices be compensated for the ‘systematic failure’ of PCSE, and indemnified against any claims as a result of support service issues.

The timetable by Primary Care Support England – the arm of Capita that manages the services – shows that new services for payments, screenings and performers list will be implemented from April 2017.

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