After Capita, we must ditch dangerous outsourcing

It’s taken a while, but the problems with Capita’s running of primary care support services has hit the public’s consciousness.

After Pulse has spent years highlighting the problems involved with patient records going missing, delays in payments for practices and GPs being unable to work due to Capita failings, the Government can now no longer ignore it.

Because its own auditors have delivered a scathing (for them) review of Capita’s primary care support services. The decision ‘potentially compromised patient safety’, said the National Audit Office, who also instructed it to consider taking services back in house.

The findings reveal that NHS England didn’t have sufficient knowledge to set Capita realistic targets, incentivised the company to close services and was unable to adequately assess the risk if Capita were to fail in its delivery of support services – which, of course, it did.

Most importantly, the auditors found that GPs are still experiencing ‘widespread failures’, with key concerns including Capita’s management of the national performers list, GP pensions and payments. All of which have huge impact on the individuals involved.

It’s easy to make such assessments in hindsight. The problem for NHS England is it was easy to make that assessment in foresight, too. In 2014, GPC contracts and regulation subcommittee chair Dr Robert Morley said: ‘The portents are absolutely horrendous for general practice, I’m afraid… there’s nothing at all that reassures me this isn’t going to be an absolute bloody disaster.’

Surely this – after the disastrous rolling out of NHS 111, too – will tell health leaders that outsourcing vital services at a national level to cut costs will almost always result in failure?

Unfortunately, I fear that there is another finding in the auditor’s report that will trump all others: that NHS England has made £60m in savings in the first two years of the contract – broadly in line with targets.

The Capita contract may be doomed. But with the Government imposing austerity cuts on the NHS, a few GPs going without their pension or being unable to work won’t be enough to convince them to keep things in house in the future. Nor will a ‘potential’ risk to patient safety. We may need to wait until we see actual harm before the Government ditches its obsession with outsourcing.

Jaimie Kaffash is editor of Pulse